Jacklyn Abreu
Tampa,FL
Summary
Healthcare professional with over 14 years of expertise in Healthcare EDI and Revenue Cycle Management, delivering measurable reductions in claim rejections and optimizing reimbursement workflows. Skilled in EDI testing, validation, eligibility verification, and root-cause data analysis to streamline integrations, ensure HIPAA-compliant exchanges, and enhance first-pass resolution rates. Proven ability to communicate and collaborate effectively across IT, billing, payers, and providers to drive system enhancements and maintain reliable data flows. Committed to continuous process innovation that accelerates collections and improves overall operational efficiency.
Overview
13
13
years of professional experience
1
1
Certification
Work History
EDI Analyst
CareCentrix
Tampa, FL
11.2021 - 01.2026
- Executed comprehensive reviews of daily EDI rejection reports, focusing on improving data accuracy and maintaining adherence to HIPAA regulations.
- Investigated and resolved rejection disputes and file transfer errors to streamline inquiry resolution processes.
- Engaged with business partners and providers to enhance data transmission reliability and improve provider satisfaction.
- Monitored and validated exchanged documents to guarantee adherence to HIPAA standards and effective compliance controls.
- Oversaw EDI clearinghouse operations utilizing Availity, Waystar, and ChangeHealth to enhance transaction consistency.
Lead Accounts Receivable Representative
CareCentrix
Tampa, FL
03.2015 - 11.2021
- Generated comprehensive data reports for revenue cycle leaders, focusing on reducing denials and elevating accounts receivable performance.
- Compiled financial trending reports to evaluate accounts receivable health and guide management decisions.
- Developed and implemented comprehensive training programs aimed at improving associates' accuracy and proficiency across the team.
- Performed rapid data-driven reporting to support denial management and optimize financial strategies.
- Collaborated with internal teams and external partners to test and implement system enhancements aimed at improving billing workflow reliability.
- Supported supervisor in distributing tasks and executing special projects to ensure timely completion of assignments.
- Compiled and analyzed data to produce accurate reports that facilitate informed decision-making and optimize follow-up actions.
- Engaged with payers to resolve claim denials, ensuring accurate claim correction and reprocessing to maintain revenue flow.
- Oversaw escalations on complex accounts by negotiating with payers and reprocessing claims to recover outstanding balances.
- Guided AR team in effective denial resolution techniques and system navigation to ensure consistent operational efficiency.
Senior Accounts Receivable Representative
CareCentrix
Tampa, FL
12.2012 - 03.2015
- Delivered training and support to customers and staff, aiming to improve account resolution speed and elevate customer satisfaction.
- Conducted thorough reviews of claim denials and implemented solutions to improve revenue flow and decrease backlog.
- Implemented corrective actions for rejections and appeals to enhance resolution of accounts.
- Executed analysis of payment variances and resolved discrepancies to ensure accurate account reconciliation.
- Proposed and executed process improvements to enhance workflow efficiency.
- Facilitated training for new hires and conducted re-education sessions for collections team to enhance overall team competency.
- Engaged with internal teams to analyze discrepancies and recommend system improvements aimed at minimizing repeat errors.
- Facilitated peer coaching on complex escalations and system navigation to enhance onboarding efficiency.
Education
Diploma -
Leto High School
Tampa01-2003
Skills
- Proficient in Microsoft 365
- Proficient in both written and verbal communication
- Effective decision making
- Root cause identification
- Verification of eligibility criteria
- Prioritization skills
- Problem-solving skills
- Revenue cycle optimization
- Managed care expertise
Websites
Certification
Lean Practionier Certified
Languages
Spanish Highly proficient
Software
SQL
Tableau
Timeline
EDI Analyst
CareCentrix
11.2021 - 01.2026
Lead Accounts Receivable Representative
CareCentrix
03.2015 - 11.2021
Senior Accounts Receivable Representative
CareCentrix
12.2012 - 03.2015
Diploma -
Leto High School