Shanna Laliberte

Florence,AZ

Summary

Dedicated Revenue Cycle professional with over 4 years of experience at East Valley Family Medical. Expert in insurance verification, denials management, and navigating complex systems like eClinicalWorks and AHCCCS. Proven track record of identifying billing discrepancies and optimizing reimbursement workflows to ensure revenue integrity.

Overview

years of professional experience

Work History

Insurance Verification Specialist

East Valley Medical

Gilbert, AZ

06.2020 - 03.2025

Optimized the claims submission process by verifying CPT/ICD-10 coding alignment, accelerating the timeline for practice reimbursement.
Resolved discrepancies in patient demographic and insurance data through cross-departmental collaboration, maintaining the integrity of the revenue cycle.
Performed comprehensive insurance eligibility and benefit verification for a high volume patient base, ensuring 100% accuracy in coverage details prior to service.
Facilitated authorization and precertification request by navigating complex payer-specific portals (Availity, AHCCCS) significantly reducing front-end denials.

Billing Specialist

OuterWare for Windows

Mesa, AZ

01.2012 - 06.2020

Processed billing statements and invoicing for clients with high accuracy.
Coordinated payment collections and resolved discrepancies efficiently.
Reviewed financial records to ensure compliance with company policies.
Trained new staff on billing procedures and software systems.

Project Manager

Green Elephant Development

Tempe, AZ

05.2005 - 08.2011

Led cross-functional teams to deliver projects on time and within budget.
Managed vendor relationships to ensure compliance with contract terms and quality standards.
Planned, designed, and scheduled phases for large projects.
Met project deadlines without sacrificing build quality or workplace safety.
Delivered exceptional customer satisfaction by proactively addressing client concerns and meeting or exceeding expectations throughout the engagement process.

Education

High School Diploma -

Mesa High School

Mesa, AZ

05.2004

Skills

Data Analysis: identifying billing trends and resolving complex claim discrepancies
Insurance Expertise: Eligibility & benefit Verification, Prior Authorizations, AHCCCS/ Medicaid Enrollment, COB (Coordination of Benefits)
Revenue Cycle: Denials Management, Claims Processing, Patient Account Auditing, Reimbursement Analysis

Compliance: HIPAA Privacy Standards, Medical Record Documentation, CMS Guidelines
Systems & EHR: eClinicalWorks (eCW), Availity Essentials, AHCCCS Online Portal, Waystar

Insurance Expertise: Eligibility & benefit Verification, Prior Authorizations, AHCCCS/Medicaid Enrollment, COB (Coordination of Benefits)

Revenue Cycle: Denials Management, Claims Processing, Patient Account Auditing, Reimbursement Analysis

Compliance: HIPAA Privacy Standards, Medical Record Documentation, CMS Guidelines

Data Analysis: identifying billing trends and resolving complex claim discrepancies

Timeline