Christina Lacy
St. Louis,MO
Summary
Healthcare and call center professionals with 10+ years of experience in medical claims processing, provider relations, benefit verification, and team leadership. Expertise in claims adjudication, appeals management, escalated issue resolution, and KPI-driven environments. Proficient in Epic, Availity, Change Healthcare, Optum, McKesson, Salesforce, and NetSuite. Dedicated professional with solid background in high-volume office environments focused on delivering exceptional clerical and operational support for professionals. Upbeat individual with friendly demeanor and sound judgment to handle diverse daily tasks with minimal oversight. Well-versed in managing office supplies, paperwork and project needs.
Overview
10
10
years of professional experience
Work History
Administrative Assistant
Loving Hand Home Health Care
10.2025 - Current
- Provide administrative and operational support for a small home health care business, assisting with daily office functions and patient-related documentation.
- Coordinate schedules, appointments, caregiver assignments, and communication between patients, caregivers, and management.
- Assisted with insurance verification, eligibility checks, authorizations, referrals, and documentation requirements to facilitate patient care.
- Communicate with patients, family members, healthcare providers, and insurance representatives to resolve questions and administrative issues.
- Maintained accurate patient and employee records, ensuring compliance with company policies for handling confidential healthcare information.
- Prepared, organized, and maintained clinical, billing, personnel, and administrative documentation to support efficient office operations.
- Utilize electronic systems, Microsoft Office, spreadsheets, and healthcare-related portals to maintain records and complete daily administrative tasks.
Provider Relations Advocate
Delta Dental Missouri
08.2024 - 10.2025
- Resolved complex provider escalations, claim disputes, and billing inquiries, enhancing provider satisfaction.
- Educated providers on policies, procedures, and regulatory requirements, ensuring compliance and reducing errors.
- Conducted root-cause analysis to reduce recurring claim issues.
- Managed claims and provider communications using claims portals, streamlining information exchange.
Sr. Claims Processor
VAYA Healthcare
07.2023 - 08.2024
- Reviewed and adjudicated medical claims, ensuring compliance with CMS guidelines to maintain regulatory standards.
- Resolved claims, eligibility, and appeals, achieving high accuracy and reducing potential discrepancies.
- Coordinated benefits, including deductibles, co-insurance, and out-of-pocket costs, facilitating clear understanding for beneficiaries.
- Executed claims processing using McKesson, Availity, and internal systems.
Sr. Provider Resolution Specialist
United Health Group
06.2016 - 04.2022
- Resolved complex provider inquiries related to claims, eligibility, benefits, authorizations, denials, payments, and account discrepancies.
- Investigated and resolved provider issues by reviewing patient accounts, payer policies, claim status, and supporting documentation.
- Collaborated with providers, insurance payers, and internal departments to identify root causes and facilitate timely resolution.
- Reprocessed erroneous claims and educated providers on appeal procedures, enhancing provider understanding and reducing future denials.
- Oversaw claims workflow using Epic, Optum, and Change Healthcare.
- Researched claim and billing discrepancies, corrected errors, and initiated appropriate adjustments, reprocessing, or appeals.
- Documented resolution activities accurately while ensuring compliance with payer requirements and organizational policies, supporting audit readiness.
- Managed high-volume provider requests, consistently meeting productivity and accuracy standards to uphold service quality.
- Utilized healthcare information systems and payer portals to research accounts, verify information, and communicate resolution outcomes.
Education
High School Diploma -
William Fleming High School
Roanoke, VA06-2008
Skills
- Medical Claims & Adjudication: CMS guidelines, prior authorizations, appeals
- Insurance verification
- Patient documentation
- Healthcare administration
- Systems: Epic, Availity, Change Healthcare, Optum, McKesson
- Microsoft Office: Word, Excel, PowerPoint, Outlook
- Database Management
- Team Coordination
Timeline
Administrative Assistant
Loving Hand Home Health Care
10.2025 - Current
Provider Relations Advocate
Delta Dental Missouri
08.2024 - 10.2025
Sr. Claims Processor
VAYA Healthcare
07.2023 - 08.2024
Sr. Provider Resolution Specialist
United Health Group
06.2016 - 04.2022
High School Diploma -
William Fleming High School