BRANDEE PARKER
Tarboro,NC
Summary
Detail-oriented team member with a strong foundation in medical standards, compliance requirements, and operational procedures. A practiced problem-solver with a friendly and caring demeanor, fostering positive interactions with colleagues and clients. Proven expertise in customer service and internal operations contributing to team success and enhancing overall organizational efficiency. Committed to upholding high-quality standards while creating a supportive environment for patients and staff.
Overview
13
13
years of professional experience
Work History
Provider Claims Representative
AmeriHealth Caritas
Remote
03.2023 - Current
- Answer incoming provider phone calls and correspondence about member benefits/eligibility and claim status
- Review and adjudicate claims according to the health plan or contractual agreement
- Reconcile audit discrepancies
- Forward claims to the appropriate department/person for further review
- Conduct detailed assessments of claims documents, ensuring accuracy and completeness before submission for approval.
Referral Coordinator
Vidant Medical Group
Greenville, NC
10.2020 - 03.2023
- Prioritized referrals according to urgency and adhered to appropriate referral deadlines
- Reviewed demographic, clinical and insurance information before scheduling patient's appointment
- Scheduled patients according to availability, urgency and insurance authorization guidelines
- Answered questions and resolved concerns raised by both patients and specialists
- Routed STAT/Urgent referrals to the appropriate nurse
- Answered telephones and directed calls to appropriate medical or administrative staff
- Entered confidential patient information and updated electronic records received via electronic fax.
Point of Service Specialist
Vidant Medical Group
Tarboro, NC
01.2013 - 10.2020
- Welcomed patrons to front desk and engaged in friendly conversations while conducting check-in and check-out process
- Handled payment processing and provided patients with receipts and proper bills and change
- Managed office phone lines by checking voicemail, returning calls and directing messages to team members
- Prepared daily shift close reports and balanced cash register to accurately reflect transactions
- Trained new staff on office procedures & insurance processes
- Oversaw office inventory by restocking supplies and submitting purchase orders
- Maintained front office cleanliness and organized supplies to increase productivity.
Education
Medical Office Administration -
Edgecombe Community College
Tarboro, NC12.2012
High School Diploma - undefined
Tarboro High School
Tarboro, NC05.2004
Skills
- Proficient in EPIC systems
- Insurance precertification processes
- Proficient in multi-line phone systems
- Patient scheduling
- Telephone etiquette
- Knowledge of HIPAA compliance
- Multitasking
- Organization
- Customer service
- Experience working remotely
- Experienced with Microsoft Office applications
Timeline
Provider Claims Representative
AmeriHealth Caritas
03.2023 - Current
Referral Coordinator
Vidant Medical Group
10.2020 - 03.2023
Point of Service Specialist
Vidant Medical Group
01.2013 - 10.2020
High School Diploma - undefined
Tarboro High School
Medical Office Administration -
Edgecombe Community College