Billie Brandie Senn
Tallahassee,FL
Summary
Florida Claims Adjuster with accomplishments as a Regulatory Analyst and Business Office Manager with a proven track record at the Department of Financial Services and USPI-Destin Surgery Center. Expert in medical billing, audit support, and fostering team development. Demonstrated success in enhancing revenue operations and ensuring regulatory compliance, leveraging strong problem-solving abilities and a commitment to excellence.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Government Analyst I – Medical Auditor
Department of Financial Services
Tallahassee, Florida
09.2022 - Current
- Company Overview: Division of Workers Compensation, Bureau of Monitoring and Audit
- Division of Workers' Compensation, Bureau of Monitoring and Audit.
- Audited company's legal documents to verify compliant policies and procedures.
- Conduct comprehensive audits of Florida Workers Compensation medical files to ensure adherence to state regulations and standards.
- Demonstrate strong problem solving skills and attention to detail in reviewing and resolving complex reporting discrepancies.
- Provided training and guidance to insurers on Florida Statutes and Rules at their locations.
Regulatory Analyst III – Claims EDI (Electronic Data Interchange)
Department of Financial Services
Tallahassee, Florida
09.2022 - 07.2024
- Company Overview: Division of Workers Compensation
- Proficient in the State of Florida Workers Compensation Statute 440.15 and Rule 69L.
- Provide training to Claim Administrator’s/ TPA.
- Provided daily and monthly reports from The Division Data Warehouse to TPA’s/ Insurer’s for re-submission of rejected First Report of Injuries to insure timely reporting
- Monitored EDI transactions to guarantee regulatory compliance.
- Performed systematic audits on EDI transactions to maintain the accuracy and integrity of data reported to the Division.
- Engaged in cross-functional team discussions to optimize EDI processes and improve performance.
- Provided Division Assigned Numbers to Claim Administrators for initial Workers Compensation Claim setup.
Business Office Specialist
Tallahassee Plastic Surgery Clinic
Tallahassee, Florida
05.2022 - 09.2023
- Provide excellent communication between patients and nursing staff for patient care requests including follow up appointments, labs, referrals, and questions/ concerns following surgery
- Utilize NextGen to schedule client appointments
- Credentialing
- Insurance verification and precertification
- Collect cosmetic fees and copays for upcoming surgeries
Business Office Manager
USPI- Destin Surgery Center
Fort Worth, TX
12.2001 - 05.2022
- Company Overview: Destin Surgery Center / Baylor Surgicare at Oakmont
- Managed the revenue cycle process for maximizing cash flow through optimal billing and collection processes
- Utilized AdvantX to review reports and prepare monthly assessments
- Performed billing, collection and reporting functions for office generating over $17 million annually
- AP Processing through Oracle and ENVI
- Proficient in Managed Care contracting including BCBS (PPO, HMO, Exchange), Aetna, UHC, Cigna, Florida Workers Compensation, Texas Workers Compensation, Medicare & Medicaid, and Auto claims
- Monitored and evaluated personnel performance to complete annual reviews, recommend advancement or address productivity concerns
- Established and developed a strong administrative team by delivering ongoing coaching and motivation and fostering career advancement
- Processed all credentialing packets for New Medical Staff / Renewals | Performed all the background verification utilizing NPDB, AMA, OIG, etc
- Completed bi-weekly payroll for 48 employees using Kronos and ADP systems
- Processed background checks for all newly hired employees
- Assisted with preparation for AAAHC and AHCA accreditation inspections
- Assisted with preparation for Joint Commission accreditation inspections
- Quarterly state reporting with the Agency for Healthcare Administration.
Education
Some College - Pre-Nursing
Northwest Florida State College
Niceville, FLSome College - General Studies
Tallahassee Community College
Tallahassee, FLSkills
- Medical Billing
- Customer Service
- Medical Coding
- Accounts Payable
- AR - Collections
- Managed Care Contracting
- Human Resources / Payroll Processing
- Credentialing
- Revenue Operations
- HIPAA Guidelines
- Process improvements
- Audit support
Certification
- State of Florida Adjuster License (All Lines), 05/31/23, G006620
- AAAHC certification
Accomplishments
- 2013 USPI Business Office Manager of the year
- Liaison for Business Office Managers – Florida region
Timeline
Government Analyst I – Medical Auditor
Department of Financial Services
09.2022 - Current
Regulatory Analyst III – Claims EDI (Electronic Data Interchange)
Department of Financial Services
09.2022 - 07.2024
Business Office Specialist
Tallahassee Plastic Surgery Clinic
05.2022 - 09.2023
Business Office Manager
USPI- Destin Surgery Center
12.2001 - 05.2022
Some College - Pre-Nursing
Northwest Florida State College
Some College - General Studies
Tallahassee Community College
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