ERICA COLON
San Juan
Summary
Dynamic Clinical Investigator Supervisor at Optum with a proven track record in revenue cycle performance and employee training. Expert in medical coding and auditing, I successfully implemented process improvements that enhanced productivity and reduced waste. Adept at fostering client relations and driving team success through effective communication and conflict resolution.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Clinical Investigator Supervisor
Optum
San Juan
03.2024 - Current
- Supervised daily operations and ensured efficient workflow among team members.
- Trained new staff on procedures and safety protocols to maintain compliance.
- Implemented process improvements to enhance productivity and reduce waste.
- Conducted performance evaluations to provide feedback and support employee development.
- Resolved conflicts within the team promptly to maintain a positive work environment.
- Monitored employee productivity to provide constructive feedback and coaching.
- Conducted weekly meetings with team members to discuss upcoming tasks and project deadlines.
- Developed strategies to improve team performance and productivity.
Medical Billing Specialist
North Texas Community Health
Fort Worth
03.2023 - 03.2024
- Submitted claims to insurance companies and researched and resolved denials and explanations of benefit rejections.
- Answered customer invoice questions and resolved issues discovered during invoicing and collection process.
- Investigated and resolved issues to maintain billing accuracy.
- Managed account receivables to maintain payments within net terms.
- Completed billing audits in identified timeframes to report and investigate findings.
- Answered customer questions to maintain high satisfaction levels.
- Managed all payments processing, invoicing and collections tasks.
- Collected, posted and managed patient account payments.
Revenue Cycle Manager
Business Advisors Md
Plano
05.2021 - 03.2023
- Managed contract administration, maintained files, validated codes and monitored reporting.
- Served as the main point of contact for client staff and management.
- Oversaw AR team leads and their AR specialist's performance in pursuing unpaid balances.
- Motivated team members to consistently achieve or exceed performance expectations.
- Communicated denial trends and train clinic staff, billing staff, and management to mitigate denials.
- Communicated client escalation items and follow-up on unresolved issues.
- Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions.
- Delegated work assignments and prioritized tasks.
AR Specialist
Ventra Health
Fort Worth
12.2019 - 11.2021
- Follows up on claim rejections and denials to ensure appropriate reimbursement for our clients.
- Achieve daily and monthly goals with minimal supervision.
- Oversaw daily collections and accounts receivable activities, developing robust strategies to maximize collections and reduce aged accounts.
- Performed routine quality assurance audits to promote data integrity.
- Meticulously tracked and resolved underpayments.
- Communicates with the insurance companies for the status on outstanding claims.
AR Specialist
Salus
Guaynabo
07.2017 - 07.2019
- Processed posting and reconciling payments and addressing aged receivables.
- Processed claims and forwarded information to Medicare, Medicaid and commercial insurance companies.
- Identified errors and re-filed denied or rejected claims in a timely manner to prevent payment delays.
- Reviewed accounts and determine appropriate follow-up actions (corrected claim, appeal, adjustments).
- Followed up with insurances for non-deposits remits.
- Reviewed daily claims submissions.
Education
Associate Degree - Administration of Office Systems with Health Billing Service
Bayamón Central University
Bayamón, PR01.2017
Skills
- Revenue cycle performance
- Problem solving oriented
- Employee training
- Medical Coding review
- Key performance indicators
- Auditing proficiency
- Multi-specialty billing
- Clients relations
- Procedure optimization
- Revenue metrics analysis
- Account analysis expertise
- CPT, ICD-10, HCPCS
- Account follow-up
- Account management
- Insurance collections
- Patient collections
Certification
- CPC, AAPC, Fort Worth, TX
- Certified Public Notary
Timeline
Clinical Investigator Supervisor
Optum
03.2024 - Current
Medical Billing Specialist
North Texas Community Health
03.2023 - 03.2024
Revenue Cycle Manager
Business Advisors Md
05.2021 - 03.2023
AR Specialist
Ventra Health
12.2019 - 11.2021
AR Specialist
Salus
07.2017 - 07.2019
Associate Degree - Administration of Office Systems with Health Billing Service
Bayamón Central University
Similar Profiles
Samantha MyersSamantha Myers
Insurance Agent at OptumInsurance Agent at Optum
Summer PalmerSummer Palmer
Manager of Clinical Operations at OptumManager of Clinical Operations at Optum
Alexandrea ByrumAlexandrea Byrum
Customer Care Representative at OptumCustomer Care Representative at Optum
Mo’neke WaltonMo’neke Walton
Sr. Install Admin at OptumSr. Install Admin at Optum
Travieso Flores Carmen M.Travieso Flores Carmen M.
Coordinadora de Salud at ASEMCoordinadora de Salud at ASEM