LASONYA WHITE

Tampa, FL ***** 813-***-**** ad4m3q@r.postjobfree.com

Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of urgency.

Claim Analyst, 06/2023 - 02/2024

Elevance Health Via BcForward Staffing – Remote

Queried databases for information needed for claim processing. Verified patient and provider information by analyzing and verifying information on provider claims. Utilized excellent analytical and problem-solving skills to quickly and accurately process claims. Checked documentation for accuracy and validity on updated systems. Utilizing Facets and CWS to meet and exceed daily production of 100-130 claims. Lead Network Services Advocate, 08/2018 - 04/2023 CareCentrix – Remote

● Analyze data determining if claims processing guidelines were followed correctly by researching plans, eligibility verification, patient authorization, and provider contract rates.

● Assisting with claim status, payments, 835/837 Electronic Remittance Advice, Accounts Receivable, payer denials, rejections, Experience with TPA Billing & Collections, reconsiderations, grievances & appeals, de-escalate complaints, provider contract education, credentialing assistance, along with other complex issues.

● Strong knowledge and experience of CMS 1500 and UB04 forms, Medical Terminology, and usage of HCPCS/Rev Codes, ICD-9, CPT, DX Codes, compiling denial letters, and identifying billing trends.

● Utilizing systems such as; Availity, to meet and exceed meeting hourly production. Worker's Compensation Client Service Team Lead, 02/2006 - 11/2013 Coventry Healthcare – Tampa, FL

● Served as Team Lead for a team of 12 FTEs researching and analyzing Workers Compensation state laws.

● Ability to identify, resolve and independently produce quality work within a timely manner with limited to no supervision.

PROFESSIONAL SUMMARY

WORK HISTORY

● Solid knowledge of Worker's Compensation & HealthCare basics, Claims terminology, and HIPAA.

● Responsible for timely follow-up in regard to client grievances.

● Ability to adapt to changes in the work environment, while dealing with and conquering demands, and other delays and unexpected events.

● Research, resolve, and adjudication of clients' high dollar claims based upon Worker's Compensation laws along with client contract education.

Customer Service Representative, Interim Team Lead, 09/2000 - 12/2005 Quest Diagnostics – Tampa, FL

● Handling customer inquiries via telephone, fax, or email regarding patient results, inquiries of tests and services, concerns of service failures, and other duties that may require supervisory attention.

● Troubleshoot inquiries and follow up with customers on issues that cannot be resolved immediately.

● Detailed Documentation of calls to maintain complete and accurate records of patient and client disputes.

● Possess great composure skills that are utilized daily in stressful situations dealing with irate customers and clients.

● Advanced to Interim Team Lead, Leading a team of 15 FTEs accepting multiple responsibilities but not limited to; Kronos, coaching, quality control, along with other managerial duties. No Degree: All Lines Adjuster, 06/2006

Hillsborough Community College - Tampa, FL

High School Diploma: 06/1998

Tampa Bay Vocationall Technical HS - Tampa, FL

EDUCATION