BETH BROWN
Bedford,IN
Summary
Provider Relations Professional with 30 years of healthcare experience. Skilled in physician billing and collections. Proven ability to develop and service networks utilizing experience and education to ensure satisfaction and quality improvement. Proven success rate of claims resolution of denied and untimely filing claim denials.
Overview
25
25
years of professional experience
Work History
Denial Management
Commonwealth Pain and Spine
02.2018 - Current
- Ensured compliance with industry regulations and guidelines during denial management activities, avoiding potential legal issues or penalties.
- Developed training materials and conducted workshops for staff on best practices in denial management.
- Actively maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third party requirements regarding billing.
- Supported revenue cycle management through efficient handling of billing-related tasks such as charge entry, payment posting, claim submission, denial management, and account followups.
- Trained new employees on denial management best practices, fostering a knowledgeable and efficient workforce.
- Maintained up-to-date knowledge of industry trends and best practices in denial management, ensuring the organization''s processes remained competitive and effective.
- Provided ongoing coaching and mentorship to junior staff members, supporting their professional growth within the field of coding denial management.
- Developed training materials for new staff, raising team's overall expertise in denial management.
- Participated in cross-functional projects focused on improving end-to-end revenue cycle performance, leveraging expertise in denial management as a key contributor.
- Demonstrated adaptability by handling various tasks such as charge entry, claims submission, or denial management when required by workload demands or staffing shortages.
- Increased department efficiency by developing comprehensive aging reports for management review.
- Implemented time management techniques to complete tasks efficiently and meet deadlines consistently.
Denial Management
Insurance Biller, Dean Dorton Health Care Solutions
09.2017 - 01.2018
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Verified patients' eligibility and claims status with insurance agencies.
- Diligently filed and followed up on third party claims.
- Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
- Accurately posted and sent out all medical claims.
- Submitted electronic/paper claims documentation for timely filing.
- Responded to correspondence from insurance companies.
- Identified and resolved patient billing and payment issues.
- Maintained and updated collections tracking spreadsheet to help organize payment information.
- Confidently and adeptly handled claim denials and/or appeals.
- Reviewed and resolved claim issues captured in TES/CLAIMS edits and the clearing house.
- Updated patient financial information to guarantee accuracy.
- Compiled and tracked outstanding balances owed to medical facilities.
- Printed and reviewed monthly patient aging report and solicited overdue payments.
Central Intake/Billing
Rescare Homecare
01.2015 - 08.2017
- Skillfully developed procedures for myself for obtaining authorizations on carrier that we had been unable to stay current of authorizations.
- Made contact and worked with the carrier to obtain back authorizations and stay current while doing so.
- Organized the department in accordance with administrative guidelines in order to provide specified authorizations for 4 states.
- Moved to a billing position, due to extensive billing and research experience to help with the back log of billing.
- Worked with Wellcare in order to find out why claims had not been paid in a 24 month period, I was able to get claims paid and polices and procedures in place.
- Led the billing department after one month in billing and collections.
- Extensive knowledge of billing, collections, researching of denied claims, overpayments and problem solving.
- Skilled at working independently and collaboratively in a team environment.
- Worked effectively in fast-paced environments.
- Self-motivated, with a strong sense of personal responsibility.
- Proven ability to learn quickly and adapt to new situations.
- Worked well in a team setting, providing support and guidance.
COLLECTIONS ACCOUNT CHAMPION SUPERVISIOR
Premier Healthcare
08.2014 - 12.2014
- Effectively supervise 14 employees.
- Precisely complete appropriate paperwork for collections and small claims court.
- Posted both patient and insurance checks and made appropriate adjustments when needed.
- Worked with patients to identify their billing questions and worked toward a solution.
INSURANCE BILLING COORDINATOR
IU Health Proton Therapy Clinic Milo B Sampson Lane
02.2012 - 12.2014
- Coordinated billing processes to ensure accurate and timely submission of insurance claims.
- Reviewed patient accounts for discrepancies, ensuring compliance with insurance policies and regulations.
- Analyzed denial reasons and developed strategies to reduce claim rejections by insurance companies.
- Safeguarded sensitive customer information through compliance with privacy laws, maintaining trust between clients and the organization.
- Increased revenue collection by diligently following up on outstanding insurance payments and negotiating settlements.
- Maintained up-to-date knowledge of industry regulations, staying informed of changes that could impact the company''s billing practices.
- Reduced billing errors through meticulous review of insurance claims and attention to detail.
- Coordinated with insurance carriers to verify patient benefits and coverage, minimizing delays in payment processing.
PATIENT ACCOUNT REPRESENTATIVE
Curtis Orthodontics
02.2001 - 02.2012
- Posted and adjusted payments from insurance companies.
- Identified and resolved patient billing and payment issues.
- Multi Phone Lines Examined patients\' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under their policies when applicable.
- Input Payroll.
- Printed and reviewed monthly patient aging report and solicited overdue payments.
- Prepared billing correspondence and maintained database to organize billing information.
Education
High School Diploma -
Borden High School
1975
Skills
- Team Leadership
- Records Management
- Medical terminology
- Computer Proficiency
- Billing oversight
- High Accuracy Claims Resolution
- Multi-Tasking
- ICD-10 Knowledge
- CPT coding Knowledge
- Excellent Problem Skills
- Chart Auditing
- Patient Chart Auditing
Timeline
Denial Management
Commonwealth Pain and Spine
02.2018 - Current
Denial Management
Insurance Biller, Dean Dorton Health Care Solutions
09.2017 - 01.2018
Central Intake/Billing
Rescare Homecare
01.2015 - 08.2017
COLLECTIONS ACCOUNT CHAMPION SUPERVISIOR
Premier Healthcare
08.2014 - 12.2014
INSURANCE BILLING COORDINATOR
IU Health Proton Therapy Clinic Milo B Sampson Lane
02.2012 - 12.2014
PATIENT ACCOUNT REPRESENTATIVE
Curtis Orthodontics
02.2001 - 02.2012
High School Diploma -
Borden High School