Veronica Talavera
Lauderhill,FL
Summary
Healthcare industry professional with 15+ years of experience, specializing in medical billing, claims processing, collections, and coordination of benefits. Expertise in Group Health Plan claims processing and appeals.
Overview
18
18
years of professional experience
Work History
HealthCare Billing and Recovery Specialist
Performant Recovery
Sunrise, FL
04.2018 - Current
- Addressed issues raised by Employers and Group Health Plans related to improper coordination of benefits.
- Conducted evaluation of beneficiary information and managed benefit data coordination.
- Managed communication with insurers and employer groups.
- Evaluated appeals and correspondence from employers and group health plans through critical decision-making skills
- Monitored communication throughout the Demand Process to meet service level agreements deadlines
- Delivered precise answers to queries from Employers and Insurers.
Payment Posting and Research Analyst
Sheridan Health Corp, Inc.
Sunrise, FL
09.2010 - 03.2018
- Posted incoming payments to billing system
- Investigated and addressed issues with unaccounted payments
- Monitored accuracy of entries through regular reporting
- Ensured compliance with contractual terms by implementing required adjustments
- Ensured high productivity through consistent speed and accuracy.
- Identify and correct errors in Batch Report
- Seamlessly navigated complex AS400 and SMART systems
- Delivered exceptional client interactions
Medical Billing and Collections Specialist
Univita Infusion
Fort Lauderdale, FL
01.2010 - 09.2010
- Reviewed, coded, and submitted claims to insurance companies and government payers.
- Followed up on unpaid or denied claims in a timely manner.
- Monitored changes in regulations related to healthcare billing practices.
- Identified discrepancies and carrier issues regarding billing and reimbursements.
- Performed insurance verification, pre-certification and pre-authorization.
Medical Billing and Payment Application Specialist
Quest Diagnostics
Fort Lauderdale, FL
10.2007 - 01.2010
- Initiated collection efforts on unpaid accounts by contacting insurance companies or patients directly via phone or mail.
- Provided customer service support to patients who had questions about their bills or payments due.
- Submitted appeals for denied claims when appropriate according to the insurance company's criteria.
- Posted payments for insurance companies, including Medicare and Medicaid, by accurately entering data into the system.
- Assisted in resolving payment issues, such as rejections or delayed payments due to incorrect coding or missing information.
Medical Billing and Collections Specialist
LabCorp of America
Fort Lauderdale, FL
12.2006 - 10.2007
- Reviewed and submitted claims to insurance companies and government payers.
- Verified patient insurance eligibility and coverage for medical services rendered.
- Followed up on unpaid or denied claims in a timely manner.
- Resolved billing discrepancies with insurance companies and patients.
- Monitored past due accounts and pursued collections on outstanding invoices.
- Responded promptly to customer inquiries regarding billing disputes or discrepancies.
Education
Bachelor of Arts - Criminal Justice
New York University
New York, NYSkills
- Medical Insurance Claims Processing
- Medical billing knowledge
- Account Management
- Customer Needs Assessment
- Team Collaboration
- Payment posting
- Quality Control Procedures
- Customer Service Excellence
Timeline
HealthCare Billing and Recovery Specialist
Performant Recovery
04.2018 - Current
Payment Posting and Research Analyst
Sheridan Health Corp, Inc.
09.2010 - 03.2018
Medical Billing and Collections Specialist
Univita Infusion
01.2010 - 09.2010
Medical Billing and Payment Application Specialist
Quest Diagnostics
10.2007 - 01.2010
Medical Billing and Collections Specialist
LabCorp of America
12.2006 - 10.2007
Bachelor of Arts - Criminal Justice
New York University
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