ELIZABETH LUNA
Rockford,IL
Summary
Experienced Revenue Cycle and Medical Reimbursement Supervisor with over 9 years of expertise in enteral and infusion therapy billing, medical claims management, and payer relations across Medicare, Medicaid, Tricare, and commercial payers. Proven success leading remote teams, optimizing reimbursement workflows, and ensuring compliance with federal and payer-specific regulations. Recognized for strong analytical ability, process improvement leadership, and a passion for coaching high-performing teams. Certified Six Sigma Green Belt | Microsoft Office Suite Expert | Work-From-Home Leadership Professional
Overview
9
9
years of professional experience
Work History
Supervisor Revenue Cycle
CVS Coram Healthcare
03.2024 - Current
- Managed intake, billing, reimbursement and accounts receivable for Medicaid, Tricare, Medicare, and managed Medicaid commercial payers on home enteral services.
- Supervised a team of nine collectors by assigning work daily based on company priorities and projects while ensuring the team was meeting productivity standards.
- Conducted bi-weekly one-on-one meetings with employees covering payer issues/changes and career skills/ development.
- Lead meetings on behalf of the company with payers covering payment policies, complex claims issues, and reimbursement options.
- Conducted audits on employee claims, verifying company/ legal policies were practiced and provided coaching as needed.
- Performed administrative duties such as payroll, timesheet review, interviews, disciplinary notices, performance reviews, staff pay rate recommendations, and resolving personnel matters.
Medicare Service Operations Claims Supervisor
Aetna
03.2022 - 03.2024
- Responsible for a team overseeing claim processing for Medicare high dollar review benefit claims.
- Supervised a stateside team of 18-30 Claim Benefit Specialists who handle claims for members and providers.
- Developed and mentored staff to provide cost-effective claim review/ processing and claim service while ensuring compliance and quality standards were met.
- Managed daily inventory basket to ensure production standards and TATs were met or exceeded.
- Allocated resources to meet volume and performance standards.
- Assessed individual and team performance and executed team process improvement.
- Acted as a liaison between staff and other areas, including management, member and provider services, communicating workflows, results, ideas, and solutions.
- Effectively applied and enforced Aetna HR policies and practices.
Senior Accounts Receivable Specialist
CVS Coram Healthcare
08.2016 - 03.2022
- Performed accounts receivable follow-up for infusion, enteral, and DME outpatient services.
- Maintained a working relationship with internal and external parties to expedite claims payments.
- Identified trends and elevated training opportunities in order to ensure cleaner claims filing.
- Trained new hires and continued developing current employees on department procedures and policies to maximize department effectiveness.
- Maintained accuracy, completeness, and security for medical records and health information.
- Advisor to the management team for developing new workplace procedures, maximizing productivity, and time management.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Resourcefully used various coding books, procedure manuals and on-line encoders.
- Guarded against fraud and abuse by verifying all coded data accurately reflected services provided.
Education
Bachelors of Science - Business Administration
Strayer University, Global Campus
06.2025
Skills
- Microsoft Office Suite (Excel, Word, PowerPoint, Outlook, Teams)
- Salesforce
- Tableau
- EPIC
- Availity
- Data Entry & Audit Tools
- Claims Management Systems
WORK FROM HOME EXPERIENCE
5+ years of remote team leadership with proven ability to manage performance, maintain productivity, and foster engagement in virtual environments.
Timeline
Supervisor Revenue Cycle
CVS Coram Healthcare
03.2024 - Current
Medicare Service Operations Claims Supervisor
Aetna
03.2022 - 03.2024
Senior Accounts Receivable Specialist
CVS Coram Healthcare
08.2016 - 03.2022
Bachelors of Science - Business Administration
Strayer University, Global Campus