Sophia Vicharelly
@sophiavicharelly
Detail-oriented professional with expertise in administrative management and HR.
What I'm looking for
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
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.
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.
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.
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.
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.
Restaurant General Manager
Dulces Mexican Restaurant
Jan 2009 - Present (16 years 6 months)
Managed all aspects of restaurant operations, ensuring efficient service and customer satisfaction.
Customer Service / Administrative Asst
SweetWater Filtration
Jan 2004 - Present (21 years 6 months)
Delivered exceptional customer service while providing administrative support to the team.
Administrative Assistant / Receptionist
Texas Staffing Resources LTD.
Jan 2003 - Present (22 years 6 months)
Provided comprehensive administrative and clerical support, managing office operations and serving as the first point of contact.
Education
Degrees, certifications, and relevant coursework
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.
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
Availability
Location
Authorized to work in
Job categories
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