Rebecca Roper Email & Phone Number

Florida

• Analyzed insurance claims to identify discrepancies, denials, or underpayments, and determine the reasons for these issues completing up to 20 accounts daily.• Applied a comprehensive approach to developing appeals for denied or underpaid insurance claims, incorporating research and compliance with industry regulations; achieved an outstanding 80% success rate in overturning denied claims.• Maintained accurate and organized records of 100% of appeals, correspondence, and relevant documentation for future reference.• Streamlined communication with insurance companies, monitoring appeals progress and coordinating with relevant stakeholders to ensure prompt resolution, reducing average resolution time by 25%.• Compiled and analyzed data on appeal outcomes, reimbursement trends, and denial reasons, resulting in a 15% reduction in denial rates and a 12% improvement in reimbursement accuracy.

Gainesville Va

Transformed employee onboarding, streamlining training process, reducing time by 40%, and boosting new hire productivity by 25%.• Developed and execute a comprehensive training logistics plan, collaborating with managers, directors, and supervisors, resulting in a seamless training experience for 100+ employees and a 20% increase in training completion rates.• Employed a robust training records management system, ensuring adherence to industry standards and regulatory requirements; achieved 100% compliance and reduced audit findings by 50% through precise record-keeping and documentation.• Initiated process improvement initiatives including job aids to boost productivity to 90%.

Pittston, Pennsylvania

Conducted detailed reviews of 50 appeals a day, verifying accuracy, completeness, and adherence to legal requirements.• Collaborated with appeal specialists to give feedback and coaching on appeal documentation and processes to achieve a 95% accuracy.• Incorporated data analytics tools to identify bottlenecks in production workflow• Implemented process improvements that reduced production time by 20% and increased overall operational efficiency by 15%.

Pittston, Pa

• Prepared subject issues for meetings with client.• Prepare synopses of appeal cases for Federal Hearing Officer.• Quality review, training and shadowing.• Team Leadership.• Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity• Created spreadsheets using Microsoft Excel for daily, weekly and monthly reporting• Used critical thinking to break down problems, evaluate solutions and make decisions

Pittston, Pennsylvania, United States

• Hired as Administrator promoted to Appeals Specialist in the first 6 months with company.• Experienced in implementing quality control measures to maintain high standards of 95% in appeals handling.• Engaged with clients or stakeholders, addressing the needs and concerns along with maintaining a 95% client satisfaction rate.• Streamlined task delegation and responsibility assignment among 5 teams, leveraging team skill sets and capabilities, resulting in a 30% reduction in project turnaround time and a 20% increase in overall team performance.

Duryea, Pennsylvania, United States

Responsible for verifying the information in facets matches the information on the claim. Gathering the information to determine if the claim is payable or should be denied. Using different calculating tools to determine the pricing for the medical claims. Customer Service

Scranton, Pennsylvania, United States

Responsibility to take calls from members and providers and answer any questions they may have had about their eligibility, billing, benefit inquiries, and claims. Assisted members of Medicare supplemental plans to enroll in plans.Started out working with a Medicare Part D prescription plan, then cross trained on a Medicare Advantage, Part C plan.

Dickson City, Pennsylvania, United States

Entered medical information and billing for insurance plans using UB and HCFA medical forms.Accuracy of 98% at 60wpm.

Bachelor'S Degree, Business Administration And Management, General

Bachelor'S Degree, Business Administration And Management, General

Associate'S Degree, Health/Health Care Administration/Management

Associate'S Degree, Health/Health Care Administration/Management