LORI VALENCIA
PUEBLO
Summary
Detail-oriented Claims Management Professional with 16 years of experience in financial accuracy and regulatory compliance within healthcare. Expertise in patient eligibility, insurance verification, and payment reconciliation enhances operational efficiency and minimizes claim rejections. Strong communicator adept at maintaining accurate electronic documentation to support confidential processes.
Overview
23
23
years of professional experience
Work History
New Account Specialist
Frontier Bank
02.2026 - Current
- Facilitated account openings and clarified banking services for clients, enhancing their understanding of available options.
- Processed account applications and verified customer identification documents.
- Explained account features and benefits to prospective customers.
- Maintained precise records of account openings and client interactions.
- Collaborated with team members to enhance client onboarding procedures.
- Cultivated client relationships through attentive service during account setup, fostering loyalty and trust.
- Delivered exceptional customer service, contributing to increased client satisfaction and retention rates.
- Utilized Microsoft Excel, Access, Word, and Outlook to manage tasks effectively.
Coding and Billing
Elaine Blinn, LCSW
02.2015 - Current
- Entered CPT codes in My Clients Plus, facilitating precise billing records and timely reimbursements.
- Submitted and tracked insurance claims, resolving issues to reduce claim rejections.
- Posted payments and co-pays to enhance accuracy of financial operations and streamline revenue cycle management.
- Verified patient data and insurance to ensure compliance and accuracy, reducing potential billing errors.
- Monitored accounts for discrepancies, ensuring prompt corrections and compliance.
Clinical Service Assistant
Elevance Health Companies
03.2021 - 07.2025
- Trained staff and providers on guidelines, improving service delivery and compliance
- Coordinated with clinical teams to streamline contract management and improve documentation accuracy
- Reviewed contracts, ensured policy adherence, and resolved complex issues
- Developed data systems for financial monitoring, enhancing compliance and efficiency
- Managed invoice processes to ensure accurate reimbursements and resolve discrepancies efficiently
Customer Service Specialists
Brighttree
01.2021 - 03.2021
- Exceeded goals through problem-solving and provided exceptional service
- Managed inbound/outbound calls to resolve issues and enhance customer satisfaction
- Processed orders accurately and met deadlines while promoting team collaboration
File Clerk, Call Center Representative, Compliance Representative, E-Referral Management Team
AeroCare Inc.
Pueblo
02.2015 - 12.2020
- Answered calls and submitted authorizations to facilitate timely patient care
- Verified physician signatures and insurance benefits
- Conducted monthly audits to maintain adherence to company standards and improve process integrity
- Utilized software platforms including Brightree, Go Scripts, ResMed, DME Hub, Parachute, Athena, and insurance portals to manage patient data
- Executed scanning and filing of documents to maintain organized records for easy access and regulatory compliance
Coding and Data Entry
Southern Co Radiologists
Pueblo
02.2014 - 01.2015
- Coded patient diagnoses from radiology reports, supporting compliance with standards
- Verified and updated patient demographics and insurance data, ensuring documentation accuracy
- Researched and corrected insurance claim denials, ensuring accurate resubmission
- Utilized Allscripts, Tiger, Co-Star, and RIS software to streamline patient data management
- Contacted patients for overdue balances, enhancing collection rates
Internship
Academy Allergy & Asthma Sinus Center
Pueblo
03.2013 - 03.2013
- Submitted insurance claims using Medisoft, resolving claim denials to ensure timely reimbursements
- Filed and maintained patient charts and superbills, supporting accurate record-keeping for efficient billing
- Processed insurance and patient payments, mailed bills, and managed past due balances to maintain cash flow
Owner
Lori's Cleaning Service
01.2007 - 12.2012
- Managed cleaning business operations, achieving high client satisfaction and retaining contracts
- Maintained service contract with ACE Cash Express, effectively meeting client needs
- Ensured meticulous service delivery and streamlined business administration
- Provided reliable, responsive customer service to address client needs
District Training Manager
ACE Cash Advance
Pueblo
09.2003 - 01.2007
- Implemented comprehensive training modules, enhancing staff competencies and performance
- Conducted 10-day training for new ACA employees, enhancing productivity
- Managed hiring, training, and discipline of staff, contributing to team development and operational growth
- Assisted District Manager in multi-unit management, improving coordination and operational effectiveness
- Achieved 232% of Revenue Plan and 175% of CIP Plan for 2004
Education
CERTIFIED CODING ASSOCIATE -
Medical Records Health Information Technologist Certificate
OFFICE MANAGEMENT -
HUMAN RELATIONS -
HEALTH ELECTRONIC BASED PROGRAMS -
Skills
- Client onboarding
- Client relationship management
- Insurance verification
- Benefit authorization
- Claims management
- Payment reconciliation
- Account reconciliation
- Document control
- Market analysis
- Critical thinking
- Liaison communication
- Confidentiality compliance
Timeline
New Account Specialist
Frontier Bank
02.2026 - Current
Clinical Service Assistant
Elevance Health Companies
03.2021 - 07.2025
Customer Service Specialists
Brighttree
01.2021 - 03.2021
Coding and Billing
Elaine Blinn, LCSW
02.2015 - Current
File Clerk, Call Center Representative, Compliance Representative, E-Referral Management Team
AeroCare Inc.
02.2015 - 12.2020
Coding and Data Entry
Southern Co Radiologists
02.2014 - 01.2015
Internship
Academy Allergy & Asthma Sinus Center
03.2013 - 03.2013
Owner
Lori's Cleaning Service
01.2007 - 12.2012
District Training Manager
ACE Cash Advance
09.2003 - 01.2007
CERTIFIED CODING ASSOCIATE -
Medical Records Health Information Technologist Certificate