Summary

Overview

Work History

Education

Skills

Websites

Timeline

Eric Lavergne

Houston

Summary

Detail-oriented individual with exceptional communication and project management skills. Proven ability to handle multiple tasks effectively and efficiently in fast-paced environments. Recognized for taking proactive approach to identifying and addressing issues, with focus on optimizing processes and supporting team objectives.

Overview

years of professional experience

Work History

Revenue Cycle Educator / Senior Revenue Cycle Billing Analyst

Integris Medical Group

01.2024 - Current

Responsible for importing and processing payment files, claim processing, collection of insurance and physician charge entry.
Executes auditing of denials, appeals, documentation, tracking, and responding to and/or resolving appeals with third-party and government payers in a timely manner.
Monitors payer files for accuracy, ensures payer documentation is completed and assist in updating files with pertinent information necessary for claim payments.
Assists in credentialing of newly onboarded physicians and clinical staff.
Conducts relevant research to assist with resolving files or claims and to stay informed on best practices and policy reforms.
Works with internal departments and external organizations to resolve complex accounts.
Regularly makes complex decisions and critical thinking within the scope of the position and working independently.
Collaborates with team members to continually improve services and engages in processes for quality improvement.
Credentialed EPIC Trainer for Front Desk Cadence teaching classes of up to 25 new hire employees.
Developed and implemented engaging lesson plans to keep learner attention.
Created lessons and online testing materials to facilitate remote learning.

Financial Clearance Associate: Blue Cross Blue Shield Team

MD Anderson Cancer Center/InGenesis

12.2020 - 11.2023

Created a positive patient experience by accurately and efficiently handling the day-to-day operations relating to financial clearance activities for diagnostic and chemotherapy patients.
Responsible for the verification of eligibility/benefits related to the verification of eligibility, pre-authorization requirements, available payment options, financial counseling and other identified financial clearance related duties.
Discussed benefit plans with patients and explained patient responsibility based on verified benefits.
Arranged calls with insurance companies and ordering physicians for denied prior authorizations.
Managed special projects as assigned by leadership (participate in claims resolution projects specific to front end related denials).
Successfully appealed claim denials related to front end, coding and billing errors.
Review payer policies when appealing denied claims and created appropriate appeal letters.
Managed claim corrections as needed.
Identified EPIC system issued and escalated as needed.
Worked with the collections team on claim resolution.
Surpassed daily production goals by 200% with an error rate of less than 2%.
Used strong analytical and problem-solving skills to develop effective solutions for challenging situations.
Excellent communication skills, both verbal and written.

Financial Clearance Supervisor & Financial Clearance Specialist (Dallas & Houston, Texas)

Nobilis Health

07.2018 - 11.2020

Supervised team of 14 financial clearance specialists for Nobilis Health facilities in Houston office.
Created goals and KPI’s for team related to managing denials specific to insurance verification, no authorization and out of network denials while streamlining workflows to improve A/R Days and increasing NPSR.
Successfully appealed claim denials related to front end, coding, and billing errors.
Reviewed payer policies when appealing denied claims and created appropriate appeal letters.
Managed claim corrections as needed.
Financially secured all surgery and diagnostic exams with authorization approvals and quotes for referrals to Nobilis facilities.
Supported leadership strategic goals specific to financial clearance team and A/R reduction while providing monthly reporting and action plans for metrics needing improvement.
Assisted in additional special projects as requested by leadership (staffing planning, goal alignment, system build, redesign to better support a functional revenue cycle, onboarding of newly acquired physicians).
Worked with collections team on claim resolution related to front-end denials.

Referral Center Supervisor/Clinic Supervisor

St. Luke’s Health System (Catholic Health Initiatives)

11.2015 - 06.2018

Created business plans for referral center operations which included staffing, EMR implementation, workflows, SOPs, and reporting.
Improved system referral integrity from 25% to 80% from employed and affiliated providers working towards meeting national goal of 85%.
Generated average of $1.5M in downstream revenue per employed provider toward facility and specialist services during first year.
Supervised and monitor daily operations and activities of employees/staff.
Monitored workflows and implement solutions to improve communication between referral center and clinics/hospitals.
Managed charge entry reconciliation and monitor charge entry lag for multiple specialties.
Partnered with practice managers and clinic administrators to ensure outstanding customer service to patients and providers.
Lead initiative for centralized insurance verification team to reduce denials and improve A/R days.
Created KPI’s for internal financial clearance/insurance verification team to meet division and national goals.
Worked with revenue cycle vendor to improve denial management related to A/R follow up and processes specific to insurance verification.
Improved verification of benefits denials from 25% of total denials to division goal of 10% for employed EPIC providers.

Insurance Verification Specialist in Emergent Care Call Center

Emerus Emergency Centers – Corporate Office Woodlands, Texas

11.2013 - 11.2015

Completed verification for all emergency centers previous days visits.
Answered calls from patients and facilities regarding insurance benefits based on incoming calls.
Verified insurance on various emergency care facility visits for daily billing reports.
Assisted in creating the verification process and procedures.
Performed edits and corrections on error accounts.
Assisted IT in special projects for EPIC conversion software.
Recouped previous unverified visits up to 6 months to prior date for billing.

Patient Insurance and Accounts Specialist

Baylor College of Medicine – Central Billing Office Houston, Texas

03.2009 - 10.2013

Obtained precertification for diagnostic testing, surgeries, and procedures in a CBO setting.
Verified patient insurance using Epic’s E-Verify system and updated patient registration information.
Reduced denial rates by ensuring accuracy of patient information and resolve patient issues.
Created monthly activity reports based on individual, team, and clinic performance.
Recognized as outstanding employee for customer service and job performance for two quarters.
Epic revenue cycle super user.
Assisted in billing, coding, collections, reconciliations for both hospital and professional claims.