1. Lisa Kathryn Lux
4000 Mullan Rd, Apt. D213
Missoula, MT 59808
lisakathrynlux@gmail.com
408-202-5900
Skill Highlights
 9+ years working experience at physical therapy office with 6 therapists
 Patient scheduling and billing management
 Skilled in patient intake procedures
 Experienced with Microsoft Word, Outlook, Excel, patient and insurance billing systems
 Customer communications
 Administrative office management
 Strong medical ethic
 Extensive insurance terminology knowledge
 Health Care billing proficiency
 Medicare compliance
 Team orientation with emphasis on company success
 Affordable Care Act enrollments
Stone Meadow Benefits and Insurance Associates Redwood City, CA
Operations Manager, December 2013 to January 2016
 Managed daily operations for California based insurance brokerage firm
 Supervised customer care team in the Philippines
 Answered phone calls from both individual and group clients and scheduled client appointments
 Responsible for creating individual client accounts on Covered California (Covered Ca) Broker Portal and
submitting electronic enrollments to Covered Ca
 Reviewed individual client incomes to determine if client was eligible for a subsidy through Covered Ca
 Submitted citizenship and income tax documentation to Covered Ca for clients to avoid enrollment delays
 Educated clients on their summary of benefits and answered questions regarding deductibles, co-
insurances, co-pays, out of pocket maximums, visit limitations for specialty services, pre-authorization
requirements
 Verified provider network status and assisted clients with locating in-network providers
 Requested medical and ancillary insurance quotes from general agencies and carriers for group clients
 Obtained census, renewal, rates, and plan summaries from carriers in preparation for open enrollment
 Responsible for overseeing group client enrollments through Ease Central Enrollment site including
importing census, downloading rates, calculating employer contributions, and tracking status of electronic
applications and waivers
 Cross trained coworkers and group clients on various functionalities and operational usage of Ease Central
 Reviewed group client employer and employee applications including payroll reports, DE9C's, W-4's, and
Articles of Incorporation
 Submitted group client enrollment documents to carriers or general agencies and verified enrollment
status

2.  Assisted clients with submitting medical and prescription claims to carriers and resolved billing
discrepancies
 Documented all client and carrier communications in Zoho CRM Database
 Determined if employer based health plans met creditable coverage requirements for Medicare age
employees and dependents
Los Gatos Orthopedic Sports Therapy Los Gatos, CA
Office Manager, January 2008 to November 2013
 Implemented front office and billing procedures that directly resulted in improved customer service and
regulatory compliance
 Directly supervised and trained administrative staff in insurance billing procedures, insurance verification,
collection procedures, and office procedures
 Interviewed and hired administrative staff
 Conducted yearly employee reviews
 Organized staff meetings and maintained minutes to ensure action item follow-up and closure
 Reorganized existing staff assignments to improve productivity in collections and billing
 Generated delinquent account letters and sent past due patient accounts to collections agency
 Created Daily Estimated Payment Schedule Report (EPS)
 Directly managed credit card transactions in Chase Paymentech Processing System
 Provided user access and managed user permissions in Clinic Controller Billing System
 Entered data for clinic's fee schedule, procedure codes, equipment codes, and office codes
 Documented all insurance and patient communications in Clinic Controller Billing System
 Managed Medicare Compliance in FOTO (Focus on Therapeutic Outcomes) to ensure appropriate use of
modifiers, G Codes, and Re-certifications
 Responsible for renewing and terminating yearly provider insurance contracts with carriers
 Submitted each therapist's licensing credentials and course certificates to carriers to maintain active
status
Patient Care Coordinator, March 2004 to January 2008
 Created patient accounts in Physical Therapy Office System (PTOS)
 Scheduled all new and current patients for initial evaluations, re-evaluations, and routine appointments
 Collected co- pays, co-insurances, and deductibles from patients
 Verified insurance benefits for insurance plan types: PPO, POS, EPO, HMO, Medicare, Worker's
Compensation, and MVA
 Explained benefit details and created customized insurance estimate for each patient
 Obtained private insurance and worker's compensation authorizations
 Appealed worker's compensation claims and consistently received additional reimbursement
 Entered procedure codes, generated claims, and submitted electronic claims through Office Ally
Clearinghouse
 Calculated Accounts Receivable and deposited money into clinic's bank account
 Contacted insurance companies regarding billing discrepancies and resolved differences
 Proofread clinical staff's initial evaluations, progress letters, and discharge letters for each patient
 Faxed patient documentation to referring physician for each patient

3. Career Resources Employment Agency
Nichols Research Mountain View, CA
Recruiter, January 2004 to March 2004
 Tallied 60-80 outbound calls per day
 Generated daily log reports
 Screened potential participants to ensure focus group requirements were met
 Interviewed qualified participants to determine proper group placement
 Prepared interview report for supervisor
 Performed data entry for each participant's demographic information
Old Republic Title Company Campbell, CA
Receptionist, July 2003 to October 2003
 Accepted six figure escrow payments and distributed to appropriate department
 Performed data entry for open escrow orders and transmitted reports to title department
 Answered multi-lined telephone with high volume of inbound calls
 Processed in and outgoing mail
 Faxed and filed escrow orders
Touch America Telecommunications Company (Acquired by 360 Networks) Missoula, MT
Customer Service Representative, February 2002 to March 2003
 Answered 90-100 inbound calls daily
 Created long distance customer accounts obtained through the Qwest acquisition
 Notified customers that their Touch America accounts were acquired by 360 Networks
 Assisted customers with international calling procedures and provided country codes
 Reviewed customer billing discrepancies and resolved differences
 Processed credit card payments
 Cancelled 50-60 accounts daily after acquisition by 360 Networks
Education
University Of Montana, Missoula, Bachelor of Arts: Communication Studies - 2001