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 inAdaptability, Creativity, Troubleshooting, Leadership skills, Self-Driven, Time Management, and Willingness to Learn
Prior authorization processing
Reporting skills
Data integrity
Documentation abilities
Understanding of medical terms
Account management
Google Workspace
Multitasking Abilities
MS Office
Written Communication
Good Telephone Etiquette
Data Entry
Cultural Awareness
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