lbasham
Networker
3 years as a Certified Coder, with 9 years of experience in the Behavioral Health field. I am seeking a Telecommute position, as I have currently relocated to Keaau, HI. Thank you for viewing
Lisa Basham, CPC
Keaau, HI
Cell (480) 286 -3507
OBJECTIVE
Highly organized, honest, team player, desires a long-term position where a multi-layer of developmental skill can be utilized to grow with a dynamic organization.
SKILLS
MS Excel, MS Word, MS Outlook, CIS State Database, Claim Track, CMHC, HMS, Adapt to new software effectively, ability to maneuver the Internet. Complete ability to handle all Office Machines, i.e. fax machine, copier, printer, Mail postage meter, and multiple phone lines.
EXPERIENCE
Mountain Health & Wellness Director of Billing 6/2010 – 2/2012
Supervise all aspects of electronic and hardcopy HCFA 1500 and UB04 claims billing and receivables with various payers. Assures timely and accurate billing processes. Responsible for hiring and supervising billing specialist(s). Conducts regular audits to ensure all standards are being met. Monitors receipt and data entry of claims. Establishes claim-processing standards to ensure compliance with Industry standards. Monitors the weekly/daily submission of claims. Maintain expertise in order to act as a resource for other members of the Finance Department. Responsible for the set up of Regional Behavioral Health Authority for Magellan Maricopa County Develop all process and procedures for billing, & eligibility.
Southwest Behavioral Health Medical Billing Manager 3/2010 – 5/2010 Supervise all aspects of electronic and hardcopy HCFA 1500 and UB04 claims billing and receivables with various payers. Assures timely and accurate billing processes. Conducts regular audits to ensure all standards are being met. Monitors receipt and data entry of claims. Reports to the Director and informed of weekly production of claims and any problems with claims processing/submission.
Magellan Health Services Data Validation Specialist 7/2009 – 2/2010
Perform data validation audits, along with Department Behavioral Health Services to determine if encounter reported supports the service documented in the clinical record. Conduct provider training in clinical record documentation and provide technical assistance. Review encounters of data for anomalies. Audit, track fraud and abuse reports to determine if fraud or abuse has occurred. Prepare written reports of findings/conclusions and report results to the appropriate government agencies. Conduct provider site visits to determine if they are in compliance with contract requirements; prepare written reports of findings and required action; monitor the completion of the required action. Responsible for quarterly reports to the Department of Behavioral Health Services on the status of the Internal Control Numbers to be corrected by the provider for all anomalies. Worked closely with internal claims departments to insure accuracy.
Cenpatico Behavioral Health Data Validation Specialist 9/2007 – 7/2009
Perform data validation audits, along with Department Behavioral Health Services to determine if encounter reported supports the service documented in the clinical record. Conduct provider training in clinical record documentation and provide technical assistance. Review encounters of data for anomalies. Audit and track fraud and abuse reports to determine if fraud or abuse has occurred. Prepare written reports of findings/conclusions and report results to the appropriate government agencies. Conduct provider site visits to determine if they are in compliance with contract requirements; prepare written reports of findings and required action; monitor the completion of the required action. On a team on 2 auditors supervised, hired, trained and evaluated new co-workers performance and job capabilities. Reported to Chief Compliance Office
ValueOptions of Arizona, Inc. 2003 - 2007
Promoted three times based on leadership and goal achievements.
ValueOptions of Arizona, Inc Adverse Event Specialist 8/2006 – 8/2007
Identify high-risk, and coordinate complete analysis of incident/accident mortalities, as well as seclusion and restraints. Work with Nurse Investigators to trend data and review outcome recommendations. Ensure appropriateness, completion and proper documentation, as mandated by DBHS protocol. Serve as a liaison between all entities involved with incident and accidents. Accurately, concisely prepare reports in order to present findings and recommendations.
ValueOptions of Arizona, Inc Case Manager 2/2005 – 08/2006
As a member of the clinical team, assisted in the collection of assessment information, service planning and delivery, by locating, referring, providing and monitoring services to consumers in accordance with their individualized service plan. Communicated and documented consumer's progress toward their recovery. Conducting frequent home visits; performing needs assessments for each consumer. Assisting consumers in obtaining additional resources (housing, counseling, etc.). Managing consumer's doctor's appointments, transportation, and other needs. Composing detailed documentation regarding each interaction with consumers. Monitoring consumers' mental health and responding to their emergency needs. Compiling status reports for probationer consumers; appearing at hearings.
ValueOptions of Arizona, Inc Office Assistant 8/2003 – 2/2005
Coordinated schedules for 6 psychiatric providers for the SMI population. Front office check-in, and scheduler, working directly with consumers. Switchboard and retrieval of medical records. Assisting consumers with their needs until seen by provider. Production of monthly reports for site performance. Managed special projects with Management as needed.
ValueOptions of Arizona, Inc Administrative Assistant II 1/2003 – 8/2003
Obtained information from Maricopa county coroner office, ValueOptions site location, and Quality Management. To assist the RN Lead Investigator with mortality reviews. Responsible for tracking data entry, minutes for meetings, reports, and medical charts. Assisted in department for special projects as needed.
Education/ Continuing Education
Graduate of Lynn Classical High School, Lynn, Massachusetts 1986
Certified Professional Coder Certification, (Specialty Behavioral Health) April 24, 2009
Level One Fingerprint Clearance Card
Training courses Completed:
§ Coding CPT, ICD-9, HCPCS Course completed
§ Co-Occurring, Consumer Benefits
§ Working with Sex Offenders
§ Residential Treatment, Transportation
§ Fraud & Abuse
§ Pulling Together with the Child and Family Team
§ Understanding of the Behavioral Health Covered Service Guide
*All Training mandated by the State completed
REFERENCE AVAILABLE UPON REQUEST
Lisa Basham, CPC
Keaau, HI
Cell (480) 286 -3507
OBJECTIVE
Highly organized, honest, team player, desires a long-term position where a multi-layer of developmental skill can be utilized to grow with a dynamic organization.
SKILLS
MS Excel, MS Word, MS Outlook, CIS State Database, Claim Track, CMHC, HMS, Adapt to new software effectively, ability to maneuver the Internet. Complete ability to handle all Office Machines, i.e. fax machine, copier, printer, Mail postage meter, and multiple phone lines.
EXPERIENCE
Mountain Health & Wellness Director of Billing 6/2010 – 2/2012
Supervise all aspects of electronic and hardcopy HCFA 1500 and UB04 claims billing and receivables with various payers. Assures timely and accurate billing processes. Responsible for hiring and supervising billing specialist(s). Conducts regular audits to ensure all standards are being met. Monitors receipt and data entry of claims. Establishes claim-processing standards to ensure compliance with Industry standards. Monitors the weekly/daily submission of claims. Maintain expertise in order to act as a resource for other members of the Finance Department. Responsible for the set up of Regional Behavioral Health Authority for Magellan Maricopa County Develop all process and procedures for billing, & eligibility.
Southwest Behavioral Health Medical Billing Manager 3/2010 – 5/2010 Supervise all aspects of electronic and hardcopy HCFA 1500 and UB04 claims billing and receivables with various payers. Assures timely and accurate billing processes. Conducts regular audits to ensure all standards are being met. Monitors receipt and data entry of claims. Reports to the Director and informed of weekly production of claims and any problems with claims processing/submission.
Magellan Health Services Data Validation Specialist 7/2009 – 2/2010
Perform data validation audits, along with Department Behavioral Health Services to determine if encounter reported supports the service documented in the clinical record. Conduct provider training in clinical record documentation and provide technical assistance. Review encounters of data for anomalies. Audit, track fraud and abuse reports to determine if fraud or abuse has occurred. Prepare written reports of findings/conclusions and report results to the appropriate government agencies. Conduct provider site visits to determine if they are in compliance with contract requirements; prepare written reports of findings and required action; monitor the completion of the required action. Responsible for quarterly reports to the Department of Behavioral Health Services on the status of the Internal Control Numbers to be corrected by the provider for all anomalies. Worked closely with internal claims departments to insure accuracy.
Cenpatico Behavioral Health Data Validation Specialist 9/2007 – 7/2009
Perform data validation audits, along with Department Behavioral Health Services to determine if encounter reported supports the service documented in the clinical record. Conduct provider training in clinical record documentation and provide technical assistance. Review encounters of data for anomalies. Audit and track fraud and abuse reports to determine if fraud or abuse has occurred. Prepare written reports of findings/conclusions and report results to the appropriate government agencies. Conduct provider site visits to determine if they are in compliance with contract requirements; prepare written reports of findings and required action; monitor the completion of the required action. On a team on 2 auditors supervised, hired, trained and evaluated new co-workers performance and job capabilities. Reported to Chief Compliance Office
ValueOptions of Arizona, Inc. 2003 - 2007
Promoted three times based on leadership and goal achievements.
ValueOptions of Arizona, Inc Adverse Event Specialist 8/2006 – 8/2007
Identify high-risk, and coordinate complete analysis of incident/accident mortalities, as well as seclusion and restraints. Work with Nurse Investigators to trend data and review outcome recommendations. Ensure appropriateness, completion and proper documentation, as mandated by DBHS protocol. Serve as a liaison between all entities involved with incident and accidents. Accurately, concisely prepare reports in order to present findings and recommendations.
ValueOptions of Arizona, Inc Case Manager 2/2005 – 08/2006
As a member of the clinical team, assisted in the collection of assessment information, service planning and delivery, by locating, referring, providing and monitoring services to consumers in accordance with their individualized service plan. Communicated and documented consumer's progress toward their recovery. Conducting frequent home visits; performing needs assessments for each consumer. Assisting consumers in obtaining additional resources (housing, counseling, etc.). Managing consumer's doctor's appointments, transportation, and other needs. Composing detailed documentation regarding each interaction with consumers. Monitoring consumers' mental health and responding to their emergency needs. Compiling status reports for probationer consumers; appearing at hearings.
ValueOptions of Arizona, Inc Office Assistant 8/2003 – 2/2005
Coordinated schedules for 6 psychiatric providers for the SMI population. Front office check-in, and scheduler, working directly with consumers. Switchboard and retrieval of medical records. Assisting consumers with their needs until seen by provider. Production of monthly reports for site performance. Managed special projects with Management as needed.
ValueOptions of Arizona, Inc Administrative Assistant II 1/2003 – 8/2003
Obtained information from Maricopa county coroner office, ValueOptions site location, and Quality Management. To assist the RN Lead Investigator with mortality reviews. Responsible for tracking data entry, minutes for meetings, reports, and medical charts. Assisted in department for special projects as needed.
Education/ Continuing Education
Graduate of Lynn Classical High School, Lynn, Massachusetts 1986
Certified Professional Coder Certification, (Specialty Behavioral Health) April 24, 2009
Level One Fingerprint Clearance Card
Training courses Completed:
§ Coding CPT, ICD-9, HCPCS Course completed
§ Co-Occurring, Consumer Benefits
§ Working with Sex Offenders
§ Residential Treatment, Transportation
§ Fraud & Abuse
§ Pulling Together with the Child and Family Team
§ Understanding of the Behavioral Health Covered Service Guide
*All Training mandated by the State completed
REFERENCE AVAILABLE UPON REQUEST