LaSonya White
Tampa
Summary
Detail-oriented professional with proven organizational skills. Capable of managing multiple projects simultaneously while maintaining high urgency. Demonstrated ability to collaborate effectively within teams to achieve project goals.
Overview
7
7
years of professional experience
Work History
Benefit Verification Specialist
Amgen via TEKSystems
Tampa
07.2024 - Current
- Worked closely with internal teams such as the billing department and utilization management team to resolve any issues related to benefit verifications.
- Managed daily workloads while meeting deadlines set by management.
- Performed follow-up calls to verify that insurance companies received requests for authorization of services.
- Initiated contact with insurance companies as necessary to obtain additional information needed for verification purposes.
- Processed benefits, verifying accuracy, and resolving discrepancies with vendors.
- Assisted teammates with benefits enrollment and changes, providing guidance on plan options and implications.
- Recently, I became a case manager, assisting field agents, providers, and customers regarding the resolution of escalated issues.
Claims Processing Specialist
Elevance Health via BCForward Staffing
Tampa
06.2023 - 02.2024
- Conducted investigations to gather evidence in support of claims resolution.
- Assessed medical records for coverage eligibility and benefit accuracy.
- Reviewed customer claims, identified discrepancies and determined appropriate course of action.
- Managed escalated cases involving high-value claims or multiple parties involved.
- Analyzed claim data to identify trends.
- Reviewed appeals filed by claimants who were dissatisfied with initial decisions made concerning their cases.
- Maintained accurate records of all claim activities in accordance with company policies.
- Reviewed and processed insurance claims following company procedures and industry regulations.
- Followed all company procedures to keep data confidential.
Provider Network Service Advocate
Carecentrix
TAMPA
09.2018 - 04.2023
- Resolved provider complaints through effective issue de-escalation strategies.
- Collaborated with internal departments to ensure the timely processing of provider appeals and reconsiderations
- Analyzed data to verify compliance with claims processing guidelines and regulations.
- Managed grievances and appeals while educating providers on contracts and credentialing processes.
- Demonstrated expertise in CMS 1500 and UB04 forms, medical terminology, and coding systems.
- Compiled denial letters while identifying billing trends through in-depth analysis.
- Utilized Availity, Facets, and CWS systems to achieve hourly production targets.
Education
High School Diploma -
Tampa Bay Vocational Technical H.S
Tampa, FL06-1988
Skills
- Benefit verification and claims processing
- Data analysis and medical coding
- Insurance authorization
- Customer and provider relationship management
Timeline
Benefit Verification Specialist
Amgen via TEKSystems
07.2024 - Current
Claims Processing Specialist
Elevance Health via BCForward Staffing
06.2023 - 02.2024
Provider Network Service Advocate
Carecentrix
09.2018 - 04.2023
High School Diploma -
Tampa Bay Vocational Technical H.S
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