Deve'ona Lepierro
Fairfield,USA
Summary
Adept at navigating complex claims processes and enhancing customer satisfaction, my tenure at Centene honed my expertise in claims review and quality assurance. With a solid foundation in medical terminology and a knack for efficient time management, I consistently exceeded performance targets, ensuring accuracy and compliance in high-stakes environments.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Claims Analyst
Centene
Remote, US
08.2022 - 06.2024
- Claims Processing: Accurately review, analyze, and adjudicate dental insurance claims in compliance with policy guidelines, contractual agreements, and state regulations.
- Data Verification: Verify patient information, treatment plans, and coding accuracy (e.g., CDT codes) to ensure proper claims processing.
- Decision Making: Approve or deny claims based on dental policies, medical necessity, and documentation provided by dentists or patients.
- Communication: Collaborate with dental providers, patients, and insurance teams to resolve claim inquiries, discrepancies, and appeals.
- Documentation: Maintain detailed records of processed claims and ensure compliance with HIPAA and company confidentiality policies.
- Problem Solving: Investigate complex claims issues, identify errors or fraudulent activities, and recommend corrective actions.
- Knowledge Management: Stay up-to-date with industry standards, insurance policy updates, and dental terminology to improve claim review accuracy.
- Quality Assurance: Ensure high levels of accuracy and efficiency while meeting performance targets and deadlines.
- Customer Service: Provide professional and courteous support to stakeholders regarding claim statuses, benefits, and payment explanations.
Member Service Rep II
United HealthGroup
Fairfield, US
04.2018 - 07.2022
- Maintain high standards of customer service during high volume, fast-paced operations
- Handle financial transactions quickly and accurately via EPIC payment posting
- Verified insurance eligibility, payments and deductibles
- Build positive relationships with customers through approachable and friendly interactions
- Take initiative to find extra tasks when scheduled duties were completed
- Adhere to company quality assurance guidelines
Cashier/Salesperson
Big 5 Sportings Good
Fairfield, US
10.2017 - 01.2018
- Manage the cash register in order to check out customers in a timely fashion
- Provide information on store products to customers, always focusing on politeness and interpersonal relationships
- Answer and return customer phone calls, providing sufficient answers to questions
- Conduct communication regarding product sales to customers
- Opening and closing of store on designated days
- Training of newly hired employees
- Assisted with inventory control
Courtesy Clerk
Safeway
San Francisco, US
05.2016 - 06.2017
- Collect shopping carts from the parking lot and transport them to the front of the story
- Sign and date rain checks
- Bag groceries
- Clean and straighten designated store areas on a regular basis
Education
Associate's Degree - Medical Billing And Coding
Carrington College California
Sacramento, CA12-2025
High school diploma or GED -
John Adams Campus, City College of San Francisco
San Francisco, CA08.2018
Skills
- Medical terminology
- Quality assurance
- ICD-10
- CPT
- Claim investigation
- Claims review
- Research
- Microsoft Word
- Medical documentation
- Microsoft Office
- Documentation review
- Microsoft Excel
- Data entry
- Time management
- Microsoft Outlook
- Microsoft Powerpoint
- Medical billing
- Dispute tracking
- Proficient in EPIC
Certification
- Driver's License, 08/01/18, 08/31/25
- Guard Card, 10/01/22, 10/31/24
- Food Handler Certification, 06/01/22, 06/30/25
Personal Information
Work Permit: Authorized to work in the US for any employer
Assessments
- Administrative assistant/receptionist, Proficient, 01/01/22
- Work motivation, Completed, 08/01/20
- Food service: Customer situations, Completed, 07/01/22
- Customer focus & orientation, Proficient, 05/01/21
- Retail customer service, Proficient, 06/01/22
- Work style: Reliability, Proficient, 01/01/22
Timeline
Claims Analyst
Centene
08.2022 - 06.2024
Member Service Rep II
United HealthGroup
04.2018 - 07.2022
Cashier/Salesperson
Big 5 Sportings Good
10.2017 - 01.2018
Courtesy Clerk
Safeway
05.2016 - 06.2017
Associate's Degree - Medical Billing And Coding
Carrington College California
High school diploma or GED -
John Adams Campus, City College of San Francisco
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