Charisma Roper
Nashville
Summary
Dynamic and results-driven professional with extensive experience in claims auditing and medical collections. Currently excelling as a Senior Recovery Resolution Analyst, specializing in auditing special referral cases, commercial, and state claims. Proven ability to analyze data, ensure compliance, and improve processes, while fostering cross-functional collaboration. Background in medical collections, skilled in resolving complex issues, negotiating payment arrangements, and maintaining regulatory standards. Committed to delivering high-quality results and continuously seeking opportunities for personal and professional growth.
Overview
18
18
years of professional experience
Work History
Senior Recovery Resolutions Analyst
Optum
11.2013 - Current
- Audit special referral cases, commercial, and state claims, ensuring accuracy and compliance with industry standards and regulations.
- Analyze claims data to identify discrepancies, recovery opportunities, and trends, leading to process improvements.
- Collaborate with cross-functional teams to resolve complex claims issues and streamline recovery operations.
- Implement corrective actions and provide feedback to improve claims processing and recovery workflows.
- Prepare detailed reports for management, highlighting audit findings, recovery performance, and recommendations for process enhancements.
Customer Account Specialist
Community Health System
07.2006 - 11.2013
- Managed inbound and outbound calls to patients and insurance companies regarding medical collections.
- Communicated effectively with patients to resolve outstanding balances, answer billing inquiries, and arrange payment plans.
- Collaborated with insurance companies to verify coverage, process claims, and address any discrepancies.
- Utilized negotiation skills to secure timely payments and resolve delinquent accounts.
- Maintained accurate records of collection activities and account statuses in compliance with HIPAA regulations.
- Assisted in preparing reports on collection progress and contributed to process improvements in the collections department.
Education
Bachelor's - Business
Capella University
High school or equivalent -
Lebanon High School
Lebanon, TN05.2000
Skills
- Claims Auditing (Special Referral, Commercial, Community and State)
- Process Improvement & Efficiency
- Problem-Solving & Resolution
- Cross-functional collaboration
Timeline
Senior Recovery Resolutions Analyst
Optum
11.2013 - Current
Customer Account Specialist
Community Health System
07.2006 - 11.2013
Bachelor's - Business
Capella University
High school or equivalent -
Lebanon High School
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