Hi, I’m
SOPHIA WHITNEY COLON
Loxahatchee,Florida
Summary
Experienced Insurance Specialist successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering eight years of experience and willingness to take on any challenge.
Overview
8
years of professional experience
6
years of post-secondary education
Work History
HumanaLouisville, KY
Remote Grievance and Appeals Specialist
01.2021 - Current
Job overview
- Manage client and provider medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted
- Provide administrative and customer support duties that require independent initiative and judgment
- Prioritize requests and interpret procedures, processes, and techniques
Anne Arundel Medical CenterAnnapolis, MD
Patient Finance Specialist
01.2020 - 01.2021
Job overview
- Prepared invoices, billed patients, and reviewed claims to ensure accuracy and timely billing to patients
- Resubmitted and contacted insurance carriers to follow up on previously billed accounts to accurately rebills when appropriate
- Advised team leaders of issues that contributed to slow payment or non-payment claims and document actions in Meditech
- Answered and resolved telephone inquiries and correspondence
- Prepared documentation and submitted for scanning daily
Anne Arundel Medical Group Physical TherapySeverna Park, MD
Office Assistant
01.2018 - 01.2020
Job overview
- Greeted and registered patients into the practice management system
- Answered phones, scheduled appointments, and assisted patients with regulatory insurance paperwork
- Communicated with insurance companies and other medical offices to obtain referrals or verifications of coverage
- Prepared reports, invoices, financial statements, and medical records in ordnance with HIPPA regulations
- Filed payments from accounts receivable, accounts payable, and patient payments
- Managed patient medical records to ensure smooth patient flow in the office
ATI Physical TherapyHanover, MD
Rehab Technician
01.2015 - 01.2017
Job overview
- Provided day to day support to clinicians
- Organized workstations, disinfected equipment and maintained the overall cleanliness of the clinic to ensure equipment is in order and ready for use
- Ordered supplies, completed patient forms, answered phones, and maintained overall inventory
- Partnered with Physical Therapy staff to discuss and evaluate patient treatment
- Demonstrated patient exercises to ensure accuracy on equipment usage
- Scheduled patient appointments with physical therapists and coordinated therapists' schedules
Education
Hopkinsville Community College
Associate of Arts
08.2014 - 05.2017
Hopkinsville Community CollegeHopkinsville, KY
Associate of Science
08.2014 - 05.2017
Skills
Proficient inundefined
Accomplishments
- Used Microsoft Excel to develop inventory tracking spreadsheets.
- Documented and resolved provider and member appeals which led to 70-80 case closures a month.
- Achieved production and quality metrics by completing appeals with accuracy and efficiency.
Timeline
Remote Grievance and Appeals Specialist
Humana
01.2021 - Current
Patient Finance Specialist
Anne Arundel Medical Center
01.2020 - 01.2021
Office Assistant
Anne Arundel Medical Group Physical Therapy
01.2018 - 01.2020
Rehab Technician
ATI Physical Therapy
01.2015 - 01.2017
Hopkinsville Community College
Associate of Arts
08.2014 - 05.2017
Hopkinsville Community College
Associate of Science
08.2014 - 05.2017
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