Iola Lehotay
Grove City
Summary
Pursuing full-time role that presents professional challenges and leverages interpersonal skills, effective time management, and problem-solving expertise.
Overview
27
27
years of professional experience
Work History
Payment Accuracy Specialist 1
Cotiviti Inc.
Draper, UT
06.2021 - Current
- Perform research analytics to support the recovery audit line of business.
- Assist in the development and implementation of new data mining and audit/review methodologies for identifying healthcare overpayment to providers.
- Collaborated with cross-functional teams to streamline workflows and reduce errors.
- Mentored junior staff on analytical tools and methodologies, enhancing team performance.
- Conducted quality assurance reviews to ensure compliance with industry standards.
- Followed all company policies and procedures to deliver quality work.
Medical Claims Auditor II
HMS Holdings
Dallas, TX
08.2016 - 06.2021
- Conducted comprehensive audits of claims to ensure compliance with federal regulations and company policies.
- Identified discrepancies in claims processing, recommending actionable solutions for improvement.
- Collaborated with cross-functional teams to streamline claim workflows and enhance operational efficiency.
- Mentored junior auditors on best practices for claims review and auditing techniques.
- Collaborated with other departments as needed to ensure seamless communication during the claims process, promoting effective teamwork across the organization.
- Reduced claim overpayments with comprehensive analysis of billing discrepancies and adherence to company policies.
Admissions Coordinator
OhioHealth Rehabilition Hosp
Columbus, OH
07.2013 - 08.2016
- Coordinated admissions processes to ensure timely patient intake and accurate documentation.
- Managed communication between patients, families, and healthcare teams to facilitate seamless transitions.
- Developed and implemented efficient scheduling practices for patient assessments and consultations.
- Streamlined application procedures to enhance operational efficiency and improve patient experiences.
Medical Claims Examiner
Business Administrator & Consultants
Reynoldsburg, OH
07.1999 - 11.2012
- Reviewed and processed medical claims for accuracy and compliance with regulations.
- Collaborated with healthcare providers to resolve claim discrepancies and ensure timely payments.
- Conducted audits on submitted claims to identify trends and prevent fraudulent activities.
- Mentored junior examiners on best practices in claims processing and regulatory requirements.
Education
No Degree - Nursing
Columbus State Community College
Columbus, OHCertificate of Completion - Medical Assistant
Aristotle Institute
Westerville, OHSkills
- Quality assurance
- Analytical thinking
- Data mining
- Expert problem solving
- Document control
Timeline
Payment Accuracy Specialist 1
Cotiviti Inc.
06.2021 - Current
Medical Claims Auditor II
HMS Holdings
08.2016 - 06.2021
Admissions Coordinator
OhioHealth Rehabilition Hosp
07.2013 - 08.2016
Medical Claims Examiner
Business Administrator & Consultants
07.1999 - 11.2012
No Degree - Nursing
Columbus State Community College
Certificate of Completion - Medical Assistant
Aristotle Institute