Sophia VicharellySV
Open to opportunities

Sophia Vicharelly

@sophiavicharelly

Detail-oriented professional with expertise in administrative management and HR.

United States
Message

What I'm looking for

I am looking for a role that values teamwork, offers growth opportunities, and allows me to utilize my diverse skill set.

I am a highly organized and detail-oriented professional with a proven track record in administrative management, human resources, accounting, and patient coordination. My ability to multitask and problem-solve has allowed me to provide exceptional support in fast-paced environments. I possess strong interpersonal and communication skills, along with technical proficiency in various software applications, including MS Word and Excel.

Throughout my career, I have demonstrated my ability to lead teams, manage operations, and ensure compliance. My experience includes managing denial processes at Superior Health Plan, overseeing HR functions at H.R.MARC CO., INC., and processing medical claims at FirstCare Health Plan. I am fluent in Spanish, which enhances my communication with diverse populations and contributes to my effectiveness in team leadership and mentoring.

Experience

Work history, roles, and key accomplishments

SC

Denials Coordinator

Superior Health Plan Centene Corporation

Jan 2016 - Present (9 years 6 months)

Managed the complete denial process, including generating and processing denial letters, maintaining detailed denial logs, and conducting thorough denial assessments. Responsible for the accurate auditing of denied claims to identify trends and areas for improvement.

HI

Human Resources / Accounting / Payroll

H.R.MARC CO., INC.

Jan 2015 - Present (10 years 6 months)

Oversaw all aspects of new hire onboarding, benefits administration, and employee termination processes. Managed accounts receivable and payable functions, ensuring accurate and timely financial transactions. Processed weekly payroll, maintaining accurate records and ensuring compliance with regulations.

FP

Claims Analyst / Adjudicator / Processor II

FirstCare Health Plan

Jan 2013 - Present (12 years 6 months)

Efficiently reviewed, repaired, and processed a high volume of both paper and electronic medical claims. Provided weekly training sessions to newly hired team members, contributing to their rapid integration and skill development.

CK

Active Patient Coordinator

Care Options for Kids

Jan 2012 - Present (13 years 6 months)

Served as a central point of contact, coordinating seamlessly between patients, healthcare providers, and medical clinics. Ensured all patients maintained up-to-date Medicaid/CHIP coverage and were actively engaged in their required therapy treatments.

IA

Claims Analyst / Customer Service Representative / Data Specialist

Innovative Aftermarket Systems / The Sedona Group Austin

Jan 2011 - Present (14 years 6 months)

Provided comprehensive assistance to callers regarding automotive inquiries and claims, demonstrating strong problem-solving abilities. Gathered critical information to accurately determine liability in automotive claims.

Education

Degrees, certifications, and relevant coursework

Austin Community College logoAC

Austin Community College

Associate's Degree (In Progress), General Studies

2001 - 2005

Attended courses focusing on general studies and foundational subjects. Developed skills in various academic disciplines relevant to future career paths.

CS

Cedar Park High School

High School Diploma, General Studies

2001 - 2001

Completed high school education, gaining foundational knowledge and skills. Participated in various academic and extracurricular activities.

Tech stack

Software and tools used professionally

Find your dream job

Sign up now and join over 100,000 remote workers who receive personalized job alerts, curated job matches, and more for free!

Sign up
Himalayas profile for an example user named Frankie Sullivan
Sophia Vicharelly - Denials Coordinator - Superior Health Plan Centene Corporation | Himalayas