Experience

Lyra Health

• United States
• Mental Health Care
• 700 & Above Employee

• Health Plan Claims Associate

  • Mar 2022 - Present



Optum (formerly Alere Wellbeing)

• Wellness and Fitness Services
• 700 & Above Employee

• Compliance Business Analyst

  • Oct 2016 - Mar 2022

  Compliance Billing Analyst: Team Lead, 2018 -Current • Optum RX is a pharmacy benefits manager that provides Medications, Durable Medical supplies and services to Workers Compensation and Liability claimants while providing competitive cost savings to insurance providers.• As a Billing Analyst, I review and QA electronic bill file validity and manage payer responses with the finance department for timely payment and denial review. - Manages over $5M worth of outbound billing files each month• Generates Excel reports for management to communicate current billing volume and outstanding/unpaid charges• Consults as subject matter expert for billing systems - Analyzes and maintains client billing information - Provides guidance for new client onboarding - Trains team members on Processes and ProceduresCompliance Billing Analyst, 2016-2018 • Executed internal audits in Excel reports for management review • Confirmed billing formats comply with EDI standards - Includes 837 and Custom text files• Collaborated with cross functional teams to resolve complex issues• Reviewed billing discrepancies against pricing contracts and apportionment disputes.



Optum Workers’ Comp and Auto No-Fault

• United States
• Insurance
• 300 - 400 Employee

• Senior AR Representative

  • Jun 2014 - Oct 2016

  Senior Accounts Receivable Representative, 2014-2016• Resolved outstanding Workers Comp and No-Fault claim accounts in revenue cycle tracking system - Maintained client billing information• Cross-trained for unique client accounts and service level agreements• Created and updated team guidelines in Excel for efficient responses from clients Senior Accounts Receivable Representative, 2014-2016• Resolved outstanding Workers Comp and No-Fault claim accounts in revenue cycle tracking system - Maintained client billing information• Cross-trained for unique client accounts and service level agreements• Created and updated team guidelines in Excel for efficient responses from clients



Albany Medical Center

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Revenue Cycle Analyst

  • Mar 2012 - May 2014

  Revenue Cycle Analyst: Team Lead, 2013-2014•Trained new associates and delegated appropriate tasks for learning job responsibilities•Implemented standardized report functions and pivot tables for targeted review of outstanding 'partial-paid' claims.•Enhanced workflow by prioritizing SQL queries to scrub reports for managementRevenue Cycle Analyst, 2012-2013•Appealed to enforce contractual pricing for in-network and out-of-network payers •Built functions in Excel to calculate unit pricing for unique specialty rates as determined by New York State Workers Compensation Board•Collaborated across teams to complete End of Month reconciliation reports for management

• Accounts Receivable Follow-up

  • Oct 2010 - Mar 2012

  Accounts Receivable Collector, 2010-2012• Tracked outstanding accounts and created reports in Excel for management.• Escalated unpaid charges with carrier bill review representatives for proper payment• Advocated on behalf of patients for appropriate insurance coverage and payments