Knowledgeable and skilled in using Athena, and People soft program
Sophia LaVille
Senior Billing Specialist
Grosse Pointe Park,MI
Summary
Efficient Medical Billing Specialist professional with several years of experience performing various accounts receivable functions. Superior familiarity with claims procedures, collections techniques and customer query resolution.
Overview
1
1
Language
4
4
years of post-secondary education
8
8
years of professional experience
Work History
Senior Billing Specialist
Ascension St. John Hospital
Southfield, MI
12.2019 - Current
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Determined prior authorizations for medication and outpatient procedures.
- Posted and adjusted payments from insurance companies.
- Accurately posted surgeries, hospital visits and payments for assigned carriers.
- Accurately posted and sent out all medical claims.
- Evaluated patients' financial status and established appropriate payment plans.
Medical Billing Representative
St Joeseph Hospital
Ann Arbor, MI
09.2017 - 04.2019
- Assisted patients by determining financial assistance available and setting up payment plans.
- Efficiently collected payments and communicated with clients.
- Orchestrated day-to-day operations of billing department, including medical coding, payment posting, accounts receivables and collections.
- Followed up on legal claims.
- Verified proper ICD-10 coding on claims.
Medical Referral Specialist
Beaumont Farmington Hills
Farmington Hills, MI
06.2015 - 04.2017
- Assisted clients in locating resources that accepted various insurances.
- Scheduled appointments with specialists on behalf of clients.
- Coordinated with medical staff and patients to find cost-effective options for services.
- Verified insurance benefits and eligibility for procedures before referring clients.
- Facilitated organized record retrieval and access by maintaining filing system for both in-house and discharged residents.
- Coordinated front office duties, including customer service, patient scheduling and billing.
Assistant Clinic Manager
Sellinger Foot Clinic
Ann Arbor, MI, MI
09.2011 - 06.2014
- Produced monthly financial reports like income statements, balance sheets and cash flow statements for presentation to Dr. Sellinger and staff.
- Designed and introduced leadership development, coaching and team management models.
- Implemented best practice standards for billing resulting in substantial reduction of accounts receivable delays.
- Built relationships with physicians to create steady referral pipeline.
- Leveraged patient feedback and performed continuous process improvements to streamline day-to-day business operations and patient satisfaction.
Education
Associate of Science - Health Administration
Eastern Michigan University
Ypsilanti, MI 09.2009 - 12.2013
Skills
Medicare and Medicaid process
Payment posting
Proficiency in Microsoft Word, Excel, Power Point, and Outlook
Proficiency in a variety of EMR systems Epic, eClinical Works, Peoplesoft, Healthquest
Proficiency in Quick books, and Kronos payroll system
Medical terminology expert
Medical coding knowledge
General accounting
Financial Management
Software
Timeline
Senior Billing Specialist
Ascension St. John Hospital
12.2019 - Current
Medical Billing Representative
St Joeseph Hospital
09.2017 - 04.2019
Medical Referral Specialist
Beaumont Farmington Hills
06.2015 - 04.2017
Assistant Clinic Manager
Sellinger Foot Clinic
09.2011 - 06.2014
Associate of Science - Health Administration
Eastern Michigan University
09.2009 - 12.2013