Healthcare operations professional focused on claims, eligibility, benefits verification, and authorization review. Leads large teams, supports performance coaching and scheduling, and resolves processing errors while maintaining HIPAA compliance, accurate records, and efficient workflow execution.
Overview
8
8
years of professional experience
Work History
Benefits Processor
HealthSpring
Fort Lauderdale, Florida
08.2026 - Current
Reviewed benefit documents and verified data accuracy, maintaining integrity of HealthSpring records.
Resolved processing errors by applying policy guidelines and plan documents, enhancing overall claims processing accuracy.
Processed member claims enrollment forms and correspondence, ensuring timely and accurate enrollment for HealthSpring.
Entered customer information into claims and eligibility systems.
Maintained confidential health records and protected sensitive member information.
Billing Supervisor (Specialty Pharmacy)
NYU Langone Health/ New York University
05.2020 - 08.2026
Manages a team of 25+ responsible for processing authorizations for specialty pharmacy drugs and infusions
Resolved issues and escalations related to authorizations and customer service
Evaluates the performance of team members and provides feedback regarding meeting benchmarks and productivity
Managed workflow and implemented process improvements to enhance staff development
Mentored and monitored entry-level staff, supporting daily functions including scheduling, time-off requests, and workforce management
Insurance/Claims Verifier
Rand Eye Institute
01.2019 - 03.2020
Executed insurance verification for assigned payors through electronic eligibility software, telephone, or fax, ensuring timely and accurate processing of claims
Performed account maintenance by validating statement groups, financial class, and payor codes for accuracy and currency
Resubmitted claims with corrected codes, modifiers, and other PHI
Ensured compliance with HIPAA guidelines and company policies to protect patient private health information (PHI)
Benefits and Authorization Specialist
Advent Health
10.2018 - 01.2019
Verified insurance benefits, eligibility, and authorization requirements to facilitate patient access to necessary services
Tracked accounts for changes in authorization status and communicated updates to relevant stakeholders
Calculated patient estimates based on copay, coinsurance, and out of pocket information for surgical procedures
Organized patient case files and coordinated sending of clinical documentation to support timely processing of authorizations