Sonja R Qualley
Asheville,United States
Summary
Experienced professional with a proven track record in people management, database entry, and office administration. Known for reliability and consistently delivering high-quality work. Seeking part-time virtual opportunities to enhance retirement lifestyle.
Overview
16
16
years of professional experience
Work History
Financial Administrative Specialist
Veterans Administration MACPAC
12.2023 - Current
- Review and prepare claims for coding. Monitor trends, patterns, deviations and errors in returned claims. Develop and implement strategies to help billers perform at their best. Do monthly reviews of billers claims for quality assurance and provide education for any errors found. Update data base with new codes and/or prices as necessary. Monitor and work errors returned from Medicare and Commercial payers. Work as SME for training new billers and/or retraining for billers that need assistance.
- Duties and Related Skills
Lead Medical Reimbursement Tech
Veterans Administration MACPAC
01.2021 - 12.2023
- Review lines received from coding and assign all billable work to billers. Monitor the amount of work each biller has and make sure they have adequate work for their day. Assigned out overtime lines and contract lines as requested by the supervisor. Resolve outstanding high dollar claims and errors received back from Medicare and/or Commercial payers. Assist in a monthly review of clams that have been retro actively coded by coding as well as claims that have been turned off as non-billable. Assist in training new staff on proper billing procedures.
- Duties and Related Skills
Medical Reimbursement Tech
Veterans Administration MACPAC
09.2017 - 12.2020
- Ensure timely filing of all claims on worklist. Follow up daily on all claims that need correction and rebill them. I also did specialty billing. This included high dollar dialysis billing, legal billing, home health billing, non-VA care claims, ambulance bills, blood and chemotherapy claims. These claims had unique procedures that had to be considered claim by claim.
- Duties and Related Skills
Data Reporting Analyst
Kaweah Delta Medical Center
07.2010 - 09.2017
- Ensure data abstraction and submission is compliant with regulatory requirements regarding patients for CathPCI Registry and EP Device Implant Registry. Provide support and expertise on performance measurement, clinical data collection, data analysis, and reporting. Establish and maintain effective working relationships with cardiothoracic surgeons, cardiologists, and cardiac team members to facilitate accurate data collection and reporting. Submit data on a quarterly basis to the ACC and other registries as required for compliance with membership standards. Develop and implement an appropriate data collection process for outcomes measurement. Utilizes selected national databases for outcomes evaluation.
- Duties, Accomplishments and Related Skills
Account Analyst
Aym Technologies
03.2009 - 07.2010
- Billing and A/R management for Behavioral Health Providers Configure mental health provider data to ensure accurate billing to various payers-NC Medicaid, GA Medicaid, SC Medicaid, Medicare, BCBS, commercial payers and LME/MCO (Local Management Entities/Managed Care Organizations). Both electronically and paper claims.
- Duties, Accomplishments and Related Skills
Education
Technical or Occupational Certificate - Medical Assisting
San Joaquin Valley College
Visalia, CA01.1982
Some College Coursework - undefined
Walla Walla College
College Place, WA03.1977
High School Diploma - undefined
Columbia Adventist Academy
Battle Ground, WA06.1976
Skills
- Customer relations
- Proofreading
- Verbal communication
- Spreadsheet creation
- Scheduling
- Calendar management
- Confidential document control
- Travel coordination
- Registration processing
- Microsoft office
- Fast learner
- Database entry
- Filing and data archiving
Timeline
Financial Administrative Specialist
Veterans Administration MACPAC
12.2023 - Current
Lead Medical Reimbursement Tech
Veterans Administration MACPAC
01.2021 - 12.2023
Medical Reimbursement Tech
Veterans Administration MACPAC
09.2017 - 12.2020
Data Reporting Analyst
Kaweah Delta Medical Center
07.2010 - 09.2017
Account Analyst
Aym Technologies
03.2009 - 07.2010
Some College Coursework - undefined
Walla Walla College
High School Diploma - undefined
Columbia Adventist Academy
Technical or Occupational Certificate - Medical Assisting
San Joaquin Valley College
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