Summary
Overview
Work History
Education
Skills
Timeline
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Ciera Pyor

Belle Glade,FL

Summary

Experienced long-term disability analyst with 18 years of experience in the medical and insurance fields. Expertise in claims analysis, policy interpretation, and providing exceptional customer service. Utilizes excellent oral and written communication, active listening, and analytical problem-solving skills to enhance customer experiences. Implements service-oriented behaviors and understands customer desires to deliver customized solutions that build loyalty. Proficient in medical billing, coding (ICD-10 and CPT), and providing detailed medical summaries for claim evaluations. Results-oriented analyst skilled at managing and breaking down large volumes of information. Proactively identifies trends affecting business success to prevent issues in operations, workflow, and production.

Overview

19
19
years of professional experience

Work History

Long-Term Disability Analyst

The Hartford
10.2021 - Current
  • Evaluate and consolidate medical information to make ethical determinations on Long-Term Disability claims
  • Review and verify financial benefits, benefit percentages, and applicable income sources to ensure accurate benefit payment calculations
  • Deliver outstanding customer service by resolving issues and maintaining communication with stakeholders to support client retention
  • Interpret policy language and collaborate with internal and external parties to exchange pertinent Long-Term Disability claim information, upholding efficient desk management and operational standards
  • Collaborated with cross-functional teams to identify opportunities for process improvement and increased efficiency.
  • Improved internal knowledge sharing by developing comprehensive documentation outlining standard operating procedures for various tasks.
  • Conducted workplace compliance training to reduce liability risks and operate effectively.
  • Enhanced team collaboration by providing clear communication of complex findings through visualizations and reports.

Retina Injection Coordinator and Coding/Billing Specialist

South Florida Vision Associates
01.2016 - 10.2021
  • Coordinated patient surgery scheduling and ensured the preparation and sterilization of equipment adhering to medical standards
  • Managed billing and coding for surgical claims with a focus on accuracy and compliance

Medical Billing & Coding Capstone

Florida Technical College
09.2020 - 05.2021
  • Translated complex medical terminology and ensured accurate application of ICD-10 and CPT coding for various organ systems
  • Performed thorough analysis of patient health records to accurately abstract and code surgical procedures and services
  • Assigned appropriate Diagnosis Related Groups (DRGs) based on detailed examination of principal and secondary diagnoses in patient records
  • Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
  • Conducted periodic audits of billing records to identify errors or inconsistencies, ensuring proper documentation for future reference.
  • Established a positive work environment through open communication channels and active participation in team meetings, fostering a culture of collaboration and growth.
  • Posted and adjusted payments from insurance companies.

Administrative Assistant

South Florida Eye Associates
01.2014 - 01.2016
  • Managed insurance verification and appointment scheduling efficiently, ensuring seamless patient flow and service delivery
  • Processed billing and coding for daily batches and claims with a high degree of accuracy
  • Handled collection of copayments and conducted merchant transactions, maintaining accurate financial records

Retina Medical Coordinator

South Florida Eye Associates
01.2008 - 01.2016
  • Managed the preparation and sterilization of injections and medical equipment, ensuring adherence to safety and hygiene protocols
  • Coordinated the procurement of medicines and office supplies, maintaining optimal stock levels for clinical operations

Teachers Assistant

Hepburn Center
01.2006 - 01.2008
  • Provided academic support to students through one-on-one tutoring, enhancing their understanding and performance in grade-level curriculum subjects
  • Supported lead teacher with the coordination and execution of educational projects and facilitated communication during parent meetings

Education

Certification - HIPAA And Bloodborne Pathogen

Integrity Medical Training
08.2024

Associate Degree - Emergency Medical Services

HCI College
West Palm Beach, FL
08.2021

Diploma - Medical Billing and Coding

Florida Technical College
Orlando, FL
06.2021

Skills

  • CPT Coding
  • HCPCS Coding
  • ICD-10
  • EMR Utilizing Medisoft
  • Medicare
  • Medicaid
  • TRICARE
  • Health Insurance Verification
  • Typing Proficient 30 WPM
  • Diagnostic Coding
  • Procedural Coding
  • HIPAA
  • Front Desk/Receptionist Duties
  • Proficient Microsoft Suite
  • FCCPA
  • Client Confidentiality
  • Analytical Thinking
  • MS Excel
  • Team Collaboration and Leadership
  • Documentation And Reporting

Timeline

Long-Term Disability Analyst

The Hartford
10.2021 - Current

Medical Billing & Coding Capstone

Florida Technical College
09.2020 - 05.2021

Retina Injection Coordinator and Coding/Billing Specialist

South Florida Vision Associates
01.2016 - 10.2021

Administrative Assistant

South Florida Eye Associates
01.2014 - 01.2016

Retina Medical Coordinator

South Florida Eye Associates
01.2008 - 01.2016

Teachers Assistant

Hepburn Center
01.2006 - 01.2008

Associate Degree - Emergency Medical Services

HCI College

Certification - HIPAA And Bloodborne Pathogen

Integrity Medical Training

Diploma - Medical Billing and Coding

Florida Technical College

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Ciera Pyor