Lauren McMillian
Saint Louis
Summary
Detail-oriented Medical Claims Follow-Up Billing Rep with 2 years of experience in resolving complex insurance billing issues. Collaborates effectively with team members and supervisors to achieve objectives and improve workflow strategies. Identifies Payor trends to enhance revenue through best practices. Skilled in Epic, Microsoft Office 365 and Copilot, Outlook, Teams and Sharepoint, Craneware, and HIPAA compliance, with a strong record of training new hires and boosting team engagement.
Overview
25
25
years of professional experience
1
1
Certification
Work History
Patient Account Rep 1
SSM Health St Louis
Remote St Louis
02.2024 - Current
- Review EOB statements and remittances submitted by insurance companies for accuracy against provider's charges in order to follow up on disputes properly.
- Research discrepancies in patient accounts to determine appropriate resolution from checking Eligibility to Contract Maintenance to bill out to correct Payor Plans.
- Analyze claims denials from third party payers and identify potential solutions for reimbursement. Currently working UHC Variances, Anthem Denials & No Response and NSA WQ for Out Of Network Contracts across UHC & Anthem.
- Identified trends in payor discrepancies in claim payments versus contracted rates and collaborated with supervisor and team leads to enhance tip sheets on Teams.
- Participated in special projects focused on correcting claim rejection errors.
- Trained new hires on Epic Basics, focusing on efficient workflows and access to follow-up standard practices and payor communication for timely account resolution.
- Mentored new hires, fostering team morale and facilitating knowledge sharing in team huddles to support adaptability in follow-up workflows.
- Ensure compliance with company policies concerning the privacy of confidential health information.
Front Desk Concierge/Admin Assistant
Garden Villas South St. Louis, MO
St Louis
09.2018 - 05.2024
- Welcomed guests and ensured smooth check-in and check-out of our facility, provided information about amenities, services, and local attractions to our residents and their families.
- Managed front reception, screened visitors, and addressed requests from residents and families. Coordinated medical appointments and outings with resident driver.
- Acted as point of contact between departments, coordinating maintenance, deliveries, assisted living, admin, kitchen, and waitstaff.
- Operated multi-line inbound phone system, building PA, emergency pagers, walkies, building emergency notification system, and building cell phone throughout shift.
- Handled confidential information and documents with discretion, maintained their proper organization and HIPPA compliance.
- Trained to administer Covid tests and carry out quarantine protocols during Lockdown.
Home & Auto Customer Service Agent
AAA MSC Contact Center
Oklahoma City
03.2011 - 12.2012
- Assisted customers with inquiries regarding policies and claims processes for Northern California, Nevada & Utah region.
- Provided timely support for billing and payment issues, processed payments, and reinstated AAA memberships and auto policies to enhance customer satisfaction.
- Evaluated new driver qualifications, reviewed driving records, and bundled AAA products to maximize customer savings.
- Resolved customer complaints by identifying root causes and implementing One Call Resolution to improve customer experience.
- Utilized active listening and communication skills to address customer inquiries and escalate issues to supervisor.
Emergency Roadside Agent, Performance Coach
AAA MSC Contact Center
Oklahoma City
01.2010 - 03.2011
- Promoted from in-house ERS agent to Performance Coach and trainer within 6 months.
- Collaborated with dispatch, underwriting, and claims to facilitate one call resolutions and processed membership payments for reinstating stranded motorists.
- Led quarterly training classes of new recruits to get them ready to take inbound service calls for AAA members, created customized training programs to meet the specific needs of each new class and our clients.
- Facilitated team building exercises to enhance communication, teamwork, and policy knowledge.
Front Desk Receptionist
Village on the Park South Retirement Home
Oklahoma City
06.2009 - 01.2010
- Welcomed guests and residents to the Village while screening all visitors entering the building, ensuring a secure and friendly environment.
- Answered multi-line phone system and managed department radio communications and emergency pager system for urgent resident assistance.
- Kept building secure during evening hours until midnight.
- Assisted Admin staff in typing memos, creating newsletters, daily menus, faxing and photocopying, tracking receipts and records. Use of Microsoft Office, Outlook, Word, Excel, Publisher and PowerPoint daily.
- Coordinated decorations and setups for special events and holiday celebrations, enhancing overall guest experiences.
Warehouse Freight Associate
Scholastic Book Fair Inc.
Oklahoma City
08.2008 - 12.2009
- Managed outgoing and incoming UPS shipments daily, utilizing UPS label system and scanners for efficient shipment setup and inventory tracking.
- Operated forklift, electric ladder, and electric pallet jack to efficiently transfer stock from overhead storage to packing area.
- Organized and filled rolling bookcases with Scholastic Book Fair items, ensuring timely freight delivery to local schools.
- UPS Shipping Agent for Scholastic Book Fair Orders to Schools across the midwest.
Kitchen Designer, Specialty Associate
The Home Depot
Edmond
01.2007 - 01.2008
- Created custom kitchen layouts using 20/20 software to enhance client satisfaction and usability.
- Collaborated with customers to determine design preferences and budget constraints.
- Presented design concepts and material options during client consultations.
- Guided customers in selecting appliances, cabinetry, and countertops to align with design vision and budget.
- Coordinated with contractors to ensure timely project execution and quality standards.
- Oversaw project documentation for contracts, invoices, and change orders to ensure accuracy and compliance.
- Helped customers apply for Home Depot credit cards and Home Improvement Loans.
Kitchen Designer, Paint Dept, Cashier
The Home Depot
Arnold
07.2001 - 10.2005
- Specialty Sales Associate for special order Kitchens, Bathrooms including Appliances and Plumbing hardware, 20/20 CAD Certified Kitchen Designer 2004-2005, 2007-2008.
- Collaborated with customers to design custom cabinetry sales orders, enhancing their home and business environments.
- Conducted site visits for measurements and product accuracy checks, coordinating with contractors and suppliers to ensure timely project delivery.
- Assisted customers in completing applications for Home Depot credit cards and loans at the customer service desk.
- Delivered free workshops in specialty paint, lawn & garden, plumbing, and flooring, educating the public on product features and application techniques.
- Operated front end, lumber, and outdoor garden center registers and returns departments.
Education
Associates - Science
Oklahoma City Community College
Oklahoma City, OK01-2011
Skills
- Follow up claims and billing
- Patient eligibility verification
- Insurance knowledge and quoting
- Contract maitenance review
- Payment processing
- Follow-up skills
- Customer service
- HIPAA compliance
- Quality assurance
- Documentation management
- Workflow management
- Training and onboarding
- Performance coaching
- Professional written and verbal communication
- Attention to detail and analytic thinking
- Team collaboration
- Multitasking and adaptable
- Multi-line inbound/outbound calls
- Emergency messaging systems
- Typing and data entry accuracy
- Microsoft 365 and Office Suite
- Teams and Copilot
- Sharepoint
- Craneware
- Event and activity planning
- Communication skills
- Empathetic decision maker
Certification
- Coder Girl Data Analytics Cohort, Launch Code, St. Louis, MO, 03/01/21 - 08/31/21
- Home Depot 20/20 Kitchen Design Certification, 01/01/05 - 12/31/07
- Home & Auto Customer Service Agent, CSAA, 01/01/10 - 02/29/12
References
- Lisa Ferguson, 557-203-1894, Lisa.Lavall@ssmhealth.com
- Kristi Hastings, 618-339-8100, Kristi.Hastings@ssmhealth.com, SSM
- Heather McKenna, 314-843-7788, Garden Villas South
- Linda Roesch, 636-931-4829, Garden Villas South
- Tiffany Hanes, 405-740-2068, Tiffany.Hanes@csaa.com, AAA
- Kayla Burcham, 224-241-9690, Kwheelerburcham@shelterinsurance.com, AAA & Shelter
Timeline
Patient Account Rep 1
SSM Health St Louis
02.2024 - Current
Front Desk Concierge/Admin Assistant
Garden Villas South St. Louis, MO
09.2018 - 05.2024
Home & Auto Customer Service Agent
AAA MSC Contact Center
03.2011 - 12.2012
Emergency Roadside Agent, Performance Coach
AAA MSC Contact Center
01.2010 - 03.2011
Front Desk Receptionist
Village on the Park South Retirement Home
06.2009 - 01.2010
Warehouse Freight Associate
Scholastic Book Fair Inc.
08.2008 - 12.2009
Kitchen Designer, Specialty Associate
The Home Depot
01.2007 - 01.2008
Kitchen Designer, Paint Dept, Cashier
The Home Depot
07.2001 - 10.2005
Associates - Science
Oklahoma City Community College