Summary
Overview
Work History
Education
Skills
Technicalexperiencesandproficiencies
Certification
Timeline
Generic

Harmonie De'Lacroix

Punta Gorda,FL

Summary

Resourceful revenue cycle management professional with proven ability to streamline billing operations and resolve payment discrepancies. Currently studying to obtain certifications in bookkeeping, accounting and payroll with the intent to enhance and optimize skill set. Known for collaborative approach and achieving consistent results. Reliable team player with strong analytical skills and adaptability to changing needs. Well-versed at organizing and leading a team- Track record of effective communication both verbal and written. Skilled in various revenue cycle management software, regulatory compliance and customer service. Proficient with project implementation and management and accomplished in increasing organizational productivity.

Overview

18
18
years of professional experience
1
1
Certification

Work History

Patient Inquiry Research Coordinator

RadNet
07.2023 - Current
  • Obtain and confirm insurance prior authorization and contact insurance providers via phone to review and confirm status of authorizations in order to bill claims
  • Obtain information regarding patient's eligibility status with insurance companies via Availity or provider portal sites to ensure proper coverage and payment for services
  • Research accounts: regarding billing inquiries, posting of payments and charges, requesting additional information such as referrals, scripts, medical reports, proof of payment, claims billing,
  • Educated customers about billing, payment processing and support policies and procedures.
  • Review and work EOB's (explanation of benefits), rejected claims, appeals and denials - developing and tracking written correspondence
  • Managed multiple projects simultaneously, ensuring timely completion and high-quality results.
  • Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
  • Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
  • Increased first-call resolution rates by carefully listening to customers'' needs and providing accurate information based on their inquiries while
  • Expanded knowledge on medical terminology and insurance policies through continuous learning initiatives, enhancing accuracy in communication with clients.
  • Facilitated smooth communication between patients, insurance companies, and medical staff for seamless coordination of care.
  • Collaborated with team members to identify areas for improvement in customer service processes, implementing changes as needed.
  • Reduced patient wait times while improving satisfaction levels through efficient problem resolution skills tailored to each unique situation.
  • Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
  • Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Posted and adjusted payments from insurance companies.
  • Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
  • Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
  • Researched CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
  • Collected payments and applied to patient accounts.
  • Monitored changes in payer requirements, adjusting billing practices accordingly to minimize disruptions in the revenue cycle.
  • Evaluated patients' financial status and established appropriate payment plans.
  • Complete daily SmartSheet Clinops inquiries for patient accounts regarding billing, payments and insurance.
  • Software: Imagine, eRad, Availity, PhiCure, KING, Medistreams, Alvaria, Noble, Jabber

Provider Enrollment Cash Applications Specialist

Fresenius Medical Care
01.2020 - 07.2023
  • Ensured comprehensive enrollment of qualifying insurance payers for digital remittance advice.
  • Skilled at processing enrollments according to varied payer requirements.
  • Maintaining accurate and current provider enrollment data, updating rosters with payers and directories
  • Assist in enrollment issues as they relate to ERA payer enrollment and claims payments
  • Submission of ticket requests via Sharepoint to EDS department for website access to payers per TIN/NPI
  • Optimized spreadsheet sharing by making it accessible to multiple users simultaneously through SharePoint.
  • Implemented setup of payer accounts for efficient retrieval of EOB/ERA.
  • Familiarity with several healthcare clearinghouses - Zirmed/Navicure, Availity, Emdeon, Trizetto/Office Ally
  • Works with Sharepoint, Microsoft Office, SAP, Document Imaging, Soarian/Cerner/E Cube Financials/ E Cube Clinicals, NextGen
  • Coordinate with facilities and healthcare payers to execute enrollments, manage and maintain proprietary systems, provide documentation maintenance, and monitor communication from payers and proactively works with payers, in-house staff, and vendor resources to identify and resolve issues that hinders optimal and timely reimbursement

Cash Applications Specialist

Schumacher Clinical Partners
04.2018 - 12.2019
  • Handled management of receivables and insurance claim processes.
  • Delivered comprehensive training to staff on reimbursement procedures and various medical billing software applications
  • Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation
  • Managed high-volume accounts efficiently by prioritizing tasks based on urgency or potential impact on company finances.
  • Prepared documentation for accounts payable specialists.
  • Provided support during month-end close activities by finalizing reconciliations accurately within tight deadlines.
  • Balanced and verified data entries in Excel spreadsheets for all broadcast markets.
  • Retrieved daily deposit data from banking system for processing.
  • Entered approved billing adjustments to patient accounts
  • Researched payments inquiries from internal/external customers and assisted with payment reconciliations
  • Sorted lock box receipts and posted accordingly to patient accounts
  • Analyzed credit accounts to determine if refund should be processed
  • Balanced receipts and reconciled daily work batches
  • Maintained all checks and identified primary payment explanation of benefits (EOB) when secondary payor is present and referred accordingly
  • Scanned (EOB) for incorrect and/or inconsistencies in reimbursement
  • Software- Precision PBI, TeleForm, Adobe Acrobat XI , SharePoint, Centricity, Healthcare Link and Microsoft Excel
  • Reconciled daily cash receipts against bank deposits, maintaining accuracy of financial records and facilitating prompt identification of discrepancies.
  • Used data entry skills to accurately document and input statements.
  • Generated monthly billing and posting reports for management review.

Front Desk Manager - Seasonal Position

LaQuinta Inns & Suites
06.2018 - 12.2018
  • Assist General Manager with preparing Guest Experience Maker work schedules and ensuring staff adheres to schedules
  • Adjust schedules as needed to meet business needs
  • Perform assigned administrative duties such as daily reports, credit card reversals, bank deposits, accounts receivables, travel agent research, lost and found, rooming lists, office supply inventory, safety committee
  • Train Guest Experience staff in technical duties, guest service skills and professional telephone etiquette
  • Advise and consult with General Manager in situations of poor employee performance and/or improper employee behavior that may require counseling and/or discipline
  • When applicable for a specific property, book group functions and meeting room space
  • Served as Manager-on-Duty in the absence of the General Manager and Assistant General Manager
  • Welcome loyal guests and military members using the best practices outlined for each program
  • Greeted visitors and customers upon arrival, offered assistance, and answered questions to build rapport and retention.
  • Ensure Elite guests receive the designated gift upon arrival
  • Provide all guests (including groups) with a friendly, accurate and efficient check-in / check-out process while following the company’s policies and procedures
  • Prepare for check-ins before the guest arrives by using the arrivals grid, preparing express check-ins, and planning for group arrivals
  • Ensure the front desk/lobby areas remain clean, organized and ready to greet guests
  • Verify and collect guest payments and identification, ensuring all procedures are followed to protect sensitive guest information including identity and credit card information
  • Process all financial transactions with strict adherence to defined procedures
  • Operate the hotel key control system while strictly following all key safety & security procedures
  • Place timely welcome calls to ensure each check-in guest has arrived to a freshly clean, inviting room with all amenities working
  • Set up wake-up calls as requested by guests to ensure they wake up refreshed and ready to take on the day
  • Promote the La Quinta Returns loyalty program to any non-enrolled guests
  • Accurately process enrollments for guests joining the program and correctly deposit points into eligible Returns accounts
  • Provide a warm and friendly experience to potential guests inquiring about hotel reservations by focusing on the guest’s need, asking for the sale, entering and confirming the reservation details, providing the cancellation policy and offering to enroll the guest in the Returns program
  • Complete shift checklist(s) to ensure the hotel information is updated and team members are prepared for the daily activities
  • Maintain room status inventory
  • Provide guests with clear directions and recommendations for local points of interest including restaurants, shopping, local attractions, etc
  • Ensure guests are aware of available hotel services
  • Sense and respond to all guest concerns or requests in a manner which leaves the guest feeling assured and optimistic about staying with La Quinta again
  • Resolve escalated issues in a timely and appropriate manner and notify the hotel manager of any unresolved concerns to ensure proper follow-up
  • Stock and restock breakfast items such as food, drink and supplies as necessary to ensure guests have a consistent selection of items which are displayed in an appealing, clean and organized manner consistent with company standards, food handling guidelines and regulations

Medical Biller

Surgical Care Affiliates Inc.
05.2012 - 01.2018
  • Medical Insurance Billing and Claim Review – via HST, Sharepoint, Emdeon, and Zirmed
  • Perform posting charges and completion of claims to payers in timely fashion
  • Convert dosages to billable units
  • Submit billing data to insurance providers
  • Work claims and claim denials to ensure maximum reimbursement for services provided
  • Verified insurance of patients to determine eligibility.
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
  • Filed and updated patient information and medical records.
  • Ensured timely payments from insurance providers through submission of accurate and complete claims.
  • Collected payments and applied to patient accounts.
  • Reduced claim denials by meticulously reviewing patient insurance information and coding practices.
  • Posted payments and collections on regular basis.
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.

Executive Administrative Manager

EME Consulting
02.2007 - 03.2012
  • Company Overview: (Company Sold)
  • MS Office 2007, 2010, 2013 (Outlook, Word, Access, Excel, OneNote, Power Point, Publisher) Windows 8 and 10 - Apple Computers –
  • Front desk professionalism – responding to telephone inquiries with excellent phone etiquette, scheduling appointments, disseminating information, receiving visitors, and preparing correspondence
  • Maintained professional and technical knowledge by attending educational workshops; reviewing professional publication and establishing personal networks
  • Light Accounting Skills – (QuickBooks and Peachtree) preparation and logging of expense reports, spreadsheets, company budgets, accounts payable, accounts receivable, company banking, bill paying, bookkeeping, office supply ordering and invoices in a customized database
  • Administrative Coordinator- meeting planning for seminars, travel arrangements/itineraries, conferences, board meetings, birthdays, special events, social media advertising, networking and open house events
  • Provided senior-level executive support.
  • Effectively managed time and conducted analysis of operational activities.
  • Data Entry/Typing (55+WPM) -ability to effectively utilize office equipment and supplies

Education

Associate of Applied Science - Medical Billing and Coding

MedTech College
Indianapolis, IN
01.2012

Skills

  • Revenue Cycle Management
  • Medical billing -claims review, submission and processing
  • Communication and interpersonal skills
  • CPT/ICD-10/HCPCS proficiency
  • Patient account management and analysis
  • Customer Service and Patient Advocacy
  • Team leadership
  • Time management
  • Complex Problem-solving
  • Accounts receivable
  • Microsoft Office proficiency
  • Knowledgeable in various software platforms

Technicalexperiencesandproficiencies

  • Microsoft Office (Specializing in Excel)
  • Level365
  • Power Presenter
  • SAP
  • Front-facing customer service
  • Event planning
  • Business correspondence
  • Efficiently maneuvering multiple applications simultaneously
  • Website-building
  • Writing agreements, documentation guides, SOP’s
  • Noted experience in analyzing and solving business situations
  • Accounts receivables/payables
  • Project collaboration and support

Certification

  • Intuit Academy Bookeeping - Coursera - Currently pursuing
  • ADP Entry-Level Payroll Specialist- Coursera - Currently pursuing

Timeline

Patient Inquiry Research Coordinator

RadNet
07.2023 - Current

Provider Enrollment Cash Applications Specialist

Fresenius Medical Care
01.2020 - 07.2023

Front Desk Manager - Seasonal Position

LaQuinta Inns & Suites
06.2018 - 12.2018

Cash Applications Specialist

Schumacher Clinical Partners
04.2018 - 12.2019

Medical Biller

Surgical Care Affiliates Inc.
05.2012 - 01.2018

Executive Administrative Manager

EME Consulting
02.2007 - 03.2012

Associate of Applied Science - Medical Billing and Coding

MedTech College

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Harmonie De'Lacroix