VINICIA ADLER
Las Vegas
Summary
Dynamic professional with extensive experience at Anthem, excelling in claim processing and account audits. Proven ability to enhance operational efficiency through effective staff training and process improvement. Adept at financial reporting and grievance resolution, fostering strong client relationships while maintaining meticulous attention to detail. Goal-oriented and committed to delivering exceptional results.
Overview
40
40
years of professional experience
Work History
Membership Rep II E&B, Individual Enrollment
Anthem
Las Vegas
05.2018 - Current
- AR reports, various payment posting, reimbursements
- Coding / Posting of Hospital claims
- Multi monthly government reporting
- Client account audits, update client information
- Training new employee’s/ creating user friendly tool for quick reference to maneuver various company programs
- Claim processing, grievance and appeals/follow ups
Lead Billing Specialist Accounts receivable
Southwest Medical
Las Vegas
01.2006 - 10.2017
- Analyzed and established staff priorities to enhance daily operations.
- Maintained updated knowledge of advancements in information technology systems.
- Conducted client account audits and managed client information updates.
- Oversaw surgery center and physician billing, including claim submissions and denial research.
- Handled grievances and appeals, ensuring timely follow-ups.
- Trained new employees and created user-friendly tools for navigating company programs.
- Prepared corporate monthly financial reports and quarterly state reports.
- Managed staffing schedules and processed PTO requests.
Sr CSC Lead
Southwest Surgery Center
Las Vegas
05.2011 - 10.2017
- Compiled AR reports and posted various payments, ensuring accuracy in reimbursements.
- Performed coding and charge posting for Surgery Center, Physician, Anesthesia, Pain Management, Ophthalmology, and ENT services.
- Analyzed daily operations to establish staff priorities for optimal efficiency.
- Maintained up-to-date knowledge of advancements in information technology systems.
- Conducted client account audits and updated client information regularly.
- Managed grievance and appeal processes, performing timely follow-ups as necessary.
- Trained new employees while creating user-friendly tools for navigating company programs.
- Prepared corporate monthly financials and quarterly state reports efficiently.
Office Coordinator Supervisor
Capital MD
Las Vegas
01.1999 - 01.2006
- Traveled to Doctors offices to train staff for daily operations efficiently
- AR reports, various payment posting
- Client account audits/update information as needed
- Paper/Electronic claim processing/denial research
- Client account concerns
- Coding/charge posting Surgery Center and or Hospital claims, Physician, Anesthesia, Pain management, Ophthalmology
- Training new employee’s/creating user friendly tools for quick reference how to maneuver various company programs
- Corporate monthly financial/state quarterly reporting
- Staffing schedule and PTO
Manager Accounts Receivable
Cal-Penn/Western Hand Center
Thousand Oaks
01.1986 - 01.1999
- AR reports, various payment posting
- Analyzing and establishing staff priorities for daily operation
- Maintained knowledge of advances in information technology system
- Client account audits, client information updates
- Surgery Center and physician billing, Claim submissions/denial research
- Grievance and appeals/follow ups
- Training new employee’s/creating user friendly tool for better understanding how to maneuver various company programs
- Corporate monthly financial s/Quarterly state reporting
- Staffing schedule and PTO
Education
Completion Certificate - Medical Terminology I/II, Claim processing, Medical Billing
Learning Tree University
Thousand Oaks, California01.1989
Certificate - Business Management
Learning Tree University
Thousand Oaks, California01.1988
Diploma - General Studies
Oxnard High School
Oxnard, California01.1983
Skills
- Claim processing
- Payment posting
- Account audits
- Grievance resolution
- Financial reporting
- Customer relationship management
- Staff training
- Process improvement
- Information technology
- Data analysis
- Effective communication
- Problem solving
- Attention to detail
- Team collaboration
- Time management
- Patience and tolerance
- Performance tracking
- Written and oral communication
- Issue resolution
- Relationships and rapport
- Materials, applications, and other documentation
- Member service and support
- Auditing client accounts
- Coding hospital claims
- Government reporting
- Denial research
- Grievance handling
- Data entry proficiency
- Building relationships
- Goal oriented
- Team Training
- Verbal and written communication
- Staff scheduling
Timeline
Membership Rep II E&B, Individual Enrollment
Anthem
05.2018 - Current
Sr CSC Lead
Southwest Surgery Center
05.2011 - 10.2017
Lead Billing Specialist Accounts receivable
Southwest Medical
01.2006 - 10.2017
Office Coordinator Supervisor
Capital MD
01.1999 - 01.2006
Manager Accounts Receivable
Cal-Penn/Western Hand Center
01.1986 - 01.1999
Completion Certificate - Medical Terminology I/II, Claim processing, Medical Billing
Learning Tree University
Certificate - Business Management
Learning Tree University
Diploma - General Studies
Oxnard High School