Stephanie Jeffries
Cordova
Summary
Experienced with complex billing systems and financial data analysis. Utilizes analytical skills to identify and resolve billing discrepancies, ensuring accuracy. Knowledge of financial reporting and process improvement to support operational efficiency.
Billing professional prepared for role with solid history of managing billing processes and improving financial operations. Adept at streamlining workflows and resolving discrepancies to optimize revenue. Known for collaboration and reliability, with focus on achieving team goals and adapting to changing needs.
Overview
20
20
years of professional experience
Work History
Senior Billing Specialist/Authorizations-Hemophilia Disorders
St Jude Children’s Research Hospital
01.2025 - Current
- Independently execute and manage billing related tasks within pharmacy/insurance billing, accounts receivable follow up, collections & denials process.
- Work closely with internal and external teams (e.g., clients, customers) to coordinate, clarify information, and resolve issues.
- Support account receivables functions related to professional fee billing; create documents and standard reports.
- Contribute to the maintenance of all policies, systems, methods, and procedures for the effective management and control of the billing functions.
- Perform other duties as assigned to meet the goals and objectives of the department and institution.
- Submit electronic authorization requests via CoverMy Meds for specialty medications while working with insurance plans for prior authorization approvals.
- Fax authorization request with clinical to insurance providers for specialty medications.
- Process Pharmacy benefit claims in real time.
- Claim Adjudicator.
- Experience with medical billing and collection environment-medical services provider.
- Contact insurance plans via phone.
- Daily office duties.
- Daily team meetings.
Senior Billing Analyst
Sunrun Inc.
08.2022 - 05.2025
- Create manual invoices on Google sheets and Oracle per Install Partner requirements and contract.
- Review billing processes for efficiency and recommend changes and improvements, as necessary.
- Closely collaborates with ERP teams in developing, testing, and processes related to Billing enhancements.
- Identify problems, process resolution, implement action and solution timely.
- Complete pricing discrepancies and adjustments.
- Handle Billing disputes as needed.
- Communicate with Account and Sales Managers regarding pricing and customer concerns.
- Audited and corrected billing and posting documents for accuracy.
- Responded to customer concerns and questions on daily basis.
- Maintained strict confidentiality with all personal data as per company guidelines.
- Maintained up-to-date knowledge of industry regulations, ensuring compliance in all aspects of the billing process.
- Evaluated aging reports to identify members to be included in monthly outbound collection calls.
- Trained new team members on internal billing procedures, fostering a collaborative work environment for continuous improvement.
- Facilitate daily invoicing of Sunrun's customer portfolio Review of daily record.
- Enforces contract warranties, creates B2B invoices for Sunrun's various commercial relationships.
- Assist with unapplied payments and review payment information according to the invoice amount.
ENROLLMENT/BILLING REPRESENTATIVE
EXPRESS-SCRIPTS-ACCREDO
01.2020 - 08.2022
- Collect all pertinent information necessary to prepare insurance claims and bill patients.
- Prepares and reviews claims to ensure billing accuracy.
- Pursues collection activities to obtain reimbursement from payers and/or patients.
- Frequent follow up with payers and/or patients on outstanding accounts.
- Escalates delinquent and/or complex claims to Sr Billing & Reimbursement Specialists for appropriate action.
- Enter patient demographic and insurance information into the medical claim software.
- Enter patient encounter information.
- Medicare, Medicaid, PBM and commercial claim processing experience.
- Obtain authorizations/ Understand Copays, Coinsurance, & Deductibles.
- Research, correct, and re-submit rejected and denied claims.
- CE2000, RxHome, CRM, ESD/Medco processing experience.
- Prepare appeals for denied claims.
- Process coordination of benefits.
- Follow up with physician offices regarding prior authorization request.
- Outbound calls to caretakers, patients, physicians and payors.
REIMBURSEMENT BILLING SPECIALIST
EXPRESS-SCRIPTS-ACCREDO
01.2018 - 01.2020
- Collect all pertinent information necessary to prepare insurance claims and bill patients.
- Enter patient demographic and insurance information into the medical claim software.
- Enter patient encounter information.
- Medicare, Medicaid, PBM and commercial claim processing experience.
- Obtain authorizations.
- Process medical billing codes and procedure codes.
- Interpret and process (post) Explanation of Benefits (EOB's).
- Research, correct, and re-submit rejected and denied claims.
- CE2000, RxHome, CRM, ESD/Medco processing experience.
- Answer patient questions regarding charges or insurance coverage.
- Prepare appeals to denied claims.
- Process coordination of benefits.
- Follow up with physician offices regarding prior authorization request.
- Outbound calls to caretakers, patients, physicians and payors.
- Understand Copays, Coinsurance, & Deductibles.
SENIOR ELIGIBILITY ASSOCIATE
UNITED BIOSOURCE CORP-EXPRESS SCRIPTS
01.2015 - 01.2018
- Process eligibility requests according to departmental procedures.
- Quality check hardcopy and audit phone requests to ensure accuracy and exceptional customer service and forward to supervisors as needed for review.
- Provide expert assistance to team members with issues needing technical expertise.
- Serve as a point of escalation for issues requiring a higher degree of expertise or discretion to resolve and ensure timely resolution.
- Provide on-the-job training for new or existing team members.
- Mentor team to improve their understanding and skills.
- Ensure team members are familiar with resource materials including manuals and systems.
- Work with Supervisor on a strategic level defining quality assurance vision and processes.
- Assist with work distribution, expedition, and the development of work plans for team members.
- Recommend process improvements and identify repetitive problems.
- Answer, resolve and document client phone calls requesting eligibility updates and/or eligibility related issues.
- Consult with client to determine mutually beneficial solutions of eligibility issues.
- Support cross-functional departments in resolution of eligibility issues (e.g Claims, call center, account management, participant materials, mail service).
- Complete other projects and additional duties as assigned.
TAX EXAMINER
INTERNAL REVENUE SERVICE
01.2013 - 01.2015
- Utilized Internal program systems such as Employee User Portal (E.U.P), IDRS, Document 6209, Service wide Electronic Research Program (S.E.R.P), Job Aids and Internal Revenue Manual (I.R.M) and Correspondence Imaging System (CIS), Single Entry Time Reporting System (SETR.
- Analyzed and evaluate information involving identity theft and the Taxpayer Protection Program and other online databases.
- Addressed wide range of issues/problems that require unique solutions; adjusting tax, penalties and interest.
- Collect, develop, analyze, and disseminate information related to violations of tax, currency, and other laws and regulations.
- Set up installment agreements, extension to pay, resolved tax issues and problems that also included but no limited to tax fraud, un-postable, and freeze codes.
- Initiated requests for tax abatements and assessments, entity changes and monitored manual refunds.
- Allocated injured spouse forms, worked math errors, penalties and payments and amended returns by applying the tax code and assisting taxpayers in understanding and meeting their tax responsibilities.
- Research and resolve issues Operation Assistance Request (OAR'S) and other Accounts Management programs.
AUTHORIZATION SPECIALIST
SERVICE MASTER/AMERICAN HOME SHIELD
01.2011 - 01.2013
- Process technician reports to approve or deny service claims for plumbing, electrical, appliances, pool/spa, hvac.
- Notified customers of coverage decisions, resolve disputes & other escalations.
- Assist customers with service requests/scheduling of service, review contract coverage, process payment information and research service issues.
- Adhere to written correspondence and/or electronic communication according to all AHS policies.
- Follow-up with customers, contractors, and/or business partners to ensure customer service issues are resolved.
- Maintains current knowledge of all AHS policies, procedures, programs and completes required continuing education courses, train associates as needed.
CUSTOMER SERVICE REP
BLUECROSS BLUESHIELD
01.2006 - 01.2012
- Answered inbound calls in support of customer needs.
- Conveyed in a reassuring manner step by step instructions to resolve application issues.
- Reviewed and issued audits on account information and processes.
- Performed queries in multiple databases.
- Adhered to government regulations.
- Provided status of claims to all members; assist with grievance filing process, mailed claim forms as well as explain benefits to members; provide network availability to members regarding participating provider's explanation of benefits.
- Released status of medical requests, handled escalation phone calls, provide assistance to team members, assist manager in research process, and process claims.
- Reviewed health spending and flexible spending accounts to ensure transactions are accurate.
- Reviewed claims for processing accuracy, and send them for adjustment if needed in order to adhere to member's benefits, file forms, complete special assignments as assigned.
- Experience with facets systems.
PRE-SERVICE NURSE ASSISTANT
VOLUNTEER STATE HEALTH PLAN
01.2008 - 01.2011
- Answered inbound calls and made outbound calls in support of customer needs.
- Conveyed in a reassuring manner step by step instructions to resolve application issues.
- Reviewed and issued audits on account information and claims.
- Performed queries in multiple databases.
- Adhered to government regulations.
- Assisted hospitals, hospice care facilities, provider's office, physical therapy facilities, home health agencies with authorization request for Tenncare/Bluecare patients.
- Assisted nurses and physicians with any request.
- Handled medical authorization request via email, fax and phone.
Education
No Degree - Veterinary Science
University of Memphis
Memphis, TNSkills
- Relationship-building expertise
- Analytical problem solver
- Meticulous in execution
- Effective team contributor
- Analytical thinker
- Effective prioritization skills
- Detail-oriented data management
- Experience with Epic billing systems
- Pharmacy benefit management billing
- Health benefit verification
- Medical claims processing
- Patient intake management
- Cover My Meds
- Insurance eligibility verification
- CMS 1500 form expertise
- Oracle software proficiency
- Oracle Cloud expertise
- Salesforce management
- Medicare/Medicaid Claim Processing/Benefit Verification
- Durable medical equipment
- Medical/PBM Authorization Processing
- Proficient in typing 50 words per minute
- Strong track record of productivity
Timeline
Senior Billing Specialist/Authorizations-Hemophilia Disorders
St Jude Children’s Research Hospital
01.2025 - Current
Senior Billing Analyst
Sunrun Inc.
08.2022 - 05.2025
ENROLLMENT/BILLING REPRESENTATIVE
EXPRESS-SCRIPTS-ACCREDO
01.2020 - 08.2022
REIMBURSEMENT BILLING SPECIALIST
EXPRESS-SCRIPTS-ACCREDO
01.2018 - 01.2020
SENIOR ELIGIBILITY ASSOCIATE
UNITED BIOSOURCE CORP-EXPRESS SCRIPTS
01.2015 - 01.2018
TAX EXAMINER
INTERNAL REVENUE SERVICE
01.2013 - 01.2015
AUTHORIZATION SPECIALIST
SERVICE MASTER/AMERICAN HOME SHIELD
01.2011 - 01.2013
PRE-SERVICE NURSE ASSISTANT
VOLUNTEER STATE HEALTH PLAN
01.2008 - 01.2011
CUSTOMER SERVICE REP
BLUECROSS BLUESHIELD
01.2006 - 01.2012
No Degree - Veterinary Science
University of Memphis