GIANA MANGIONE
Dyer,IN
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Seeking to maintain a position that offers professional challenges utilizing finance skills including account reconciliations, discrepancies, and medical claims analysis while prioritizing accuracy and time sensitive tasks.
Overview
15
15
years of professional experience
Work History
Refunds Analyst
Digitech
07.2025 - Current
- Review 100+ refunds monthly to send to various insurance companies
- Verify eligibility for members
- Check claim status, payment information, and benefits within recognized portals including Availity
- Identify payer classification to determine if overpayments and refunds are valid
- Collaborate with cross-functional teams to resolve discrepancies
- Review EMR
- Contact attorneys and insurance companies
Recovery/Resolution Analyst, Sr.
Optum
12.2010 - 05.2025
- Review provider contracts and policies to ensure accurate rates are applied to claims
- Identify and reprocess large volumes of medical claims daily for overpayment
- Review, manage, and respond to provider denials/appeals daily
- Review medical records for accuracy in claim payment
- Maintain knowledge of benefits claim processing
- Deposited checks and worked with accounting supervisor to maintain financial records
- Strengthened financial operations by recording deposits, conducting reconciliations, and financial reporting
- Carried out time sensitive administrative tasks by communicating with clients and responding to insurance correspondence
- Entered figures using 10-key to compute data quickly
Education
Diploma -
Plainfield Central High School
Plainfield, IL06.2003
Skills
- Medical Claims Auditing
- Medical Terminology
- Physician and Hospital Contract Knowledge
- Accounts Receivable
- Account Reconciliation
- Payment Posting
- Financial Reporting
- Microsoft Office
- Communication Skills
- Analytical Skills
- Teamwork
- Detail-Oriented
- Customer Service
- 10-Key
Accomplishments
- Improved Efficiency: Reduced claim processing time through efficient workflow management.
- Enhanced Accuracy: Reduced financial discrepancies with accurate reporting and reconciliations.
- Claims Recovery: Reprocessed 200+ claims monthly, recovering over $100K in incorrect payments.
- Streamlined Operations: Managed administrative tasks weekly and improved operational efficiency.
Timeline
Refunds Analyst
Digitech
07.2025 - Current
Recovery/Resolution Analyst, Sr.
Optum
12.2010 - 05.2025
Diploma -
Plainfield Central High School