PROFESSIONAL EXPERIENCE


Patient Care Coordinator

Sonova; Lancaster, PA

(September 2023 - Present)

  • Coordinated clinical care between patients and healthcare providers.
  • Verified medical insurance coverage eligibility and benefits authorization.
  • Reconciled aging accounts receivable reports and resolved outstanding balances.
  • Validated proper coding and charge information accuracy prior to claim submission.

Revenue Cycle Claims Analyst

CorroHealth; Newtown Square, PA

(April 2023 - September 2023) - contract

  • Analyzed and resolved insurance payor denial trends and reduced outstanding A/R.
  • Identified root cause of underpaid and denied UB04 and CMS 1500 medical claims.
  • Queried Epic and EMR systems to identify and correct electronic rejected claims.
  • Resolved coordination of benefits disputes and updated insurance coverage details.

Revenue Operations Specialist

DaVita Kidney Care; Malvern, PA

(March 2018 - January 2023)

  • Performed root cause analysis of underpaid claims and demographic discrepancies.
  • Verified claims were received by insurance carriers timely and ensured processing.
  • Reduced bad debt adjustments and reported analytics on increased revenue.
  • Researched and resolved claim rejections, underpayments and denials.

Revenue Operations Analyst

MedRisk; King of Prussia, PA

(June 2016 - March 2018)

  • Queried EHR database to identify demographic and billing discrepancies.
  • Analyzed outstanding and underpaid claims and identified discrepancy trends.
  • Identified pre-adjudication intake issues and coordinated resolution with IT department.
  • Performed appropriate actions to resolve untimely processing and payment inaccuracies.

Account Executive

PureRed Integrated Marketing; Exton, PA

(July 2015 - June 2016)

  • Primary source of communication between clients and on-site production team.
  • Maintained and improved relationships with national retail clients.
  • Facilitated production of print media ensuring projects shipped timely and on budget.
  • Coordinated and executed production of proofing schedules for all print media.

Medical Insurance Specialist

Varo Healthcare; West Chester, PA

(January 2015 - July 2015) - contract

  • Corrected insurance discrepancies and verified coverage eligibility.
  • Resolved billing disputes between healthcare providers and insurance companies.
  • Submitted appeal letters to insurance carriers and confirmed claim reprocessing.
  • Identified front rejection codes to ensure accurate and timely claim processing.

Revenue Operations Analyst

Healthcare Solutions; Norristown, PA

(March 2014 - January 2015)

  • Resolved insurance inconsistencies and patient demographic inaccuracies.
  • Corrected inaccurate medical claim billed amounts and per diem rates.
  • Requested utilization review to disallow unnecessary service charges.
  • Analyzed root cause of claim rejections and underpayments.

Clinical Care Coordinator

Optum360 EHR; Newtown Square, PA

(January 2011 - March 2014)

  • Coordinated patient medical records for physician peer-to-peer review.
  • Accessed client clinical systems to obtain patient medical records.
  • Identified and corrected inaccurate patient demographic information.
  • Entered demographic and clinical information into EHR database.

EDUCATION

Temple University Philadelphia, PA 2010

Bachelor of Arts Communications