Summary
Overview
Work History
Education
Skills
Education
Timeline
Generic

Liana Sizemore

Turlock,CA

Summary

Energetic Supervisor successful at motivating and building positive team dynamics to accomplish goals. Dedicated to open, communicative culture where employees feel empowered to contribute to company's success.

Overview

14
14
years of professional experience

Work History

Supervisor, Revenue Control Management Credits/Ref

Conifer Healthcare Solutions
03.2024 - Current
  • Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
  • Improved customer satisfaction with timely response to inquiries, addressing concerns, and finding effective solutions.
  • Increased team productivity by implementing efficient workflows and setting clear expectations for staff members.
  • Enhanced communication within the team by holding regular meetings and encouraging open dialogue among all members.
  • Demonstrated commitment to the organization''s core values, leading by example and fostering a culture of excellence.

Credit Resolution Representative

Conifer Health Solutions
10.2018 - Current

Nineteen years experience as a Patient Account Representative and Appeals Specialist. Strong in depth review to determine if credit balance is correct or another action is needed to resolve account(s). Work Demand Request from the payor or patient in a timely manner while determining if refund is justified/correct. Work to resolve account with one touch and experienced at working multiple payors.

Patient Account Representative

Conifer Health Solutions
07.2011 - 05.2017
Equivalent to same position with Tenet with added responsibilities. No limitation on amount collected. Appeal claims not paid per contract, read and understand contracts to show liability to pay. Escalate exhausted appeals. Collect data to report payment variance trends. Work with multiple clients and programs.

Education

High School Diploma -

AMADOR High School
Sutter Creek, Ca

Skills

  • Multiple programs - ACE, CITRIX, Epic, HCR, PNC, IMACS, MedAssets
  • Client contact regarding claim status
  • New and aged claims
  • Access payer websites
  • Identify trending issues and provide suggestions for resolution
  • Validate dispute reasons following Explanation of Benefits review, escalate payment variance trends or issue to management, generate appeals for denied or underpaid claims
  • Document pertinent collection activity
  • Verify claims adjudication utilizing appropriate resource applications
  • Correspond with patients to obtain additional information
  • Request rebill or request to have coding reviewed
  • Manage and maintain desk inventory, desk inventory, complete reports, and resolve high priority and aged inventory
  • Goal oriented
  • Staff management
  • Training and mentoring

Education

USA

Timeline

Supervisor, Revenue Control Management Credits/Ref

Conifer Healthcare Solutions
03.2024 - Current

Credit Resolution Representative

Conifer Health Solutions
10.2018 - Current

Patient Account Representative

Conifer Health Solutions
07.2011 - 05.2017

High School Diploma -

AMADOR High School
Liana Sizemore