Brenay Brown
Las Vegas,NV
Summary
Confident, dependable, administrative professional with wide array of skills seeking a challenging and rewarding career in a diverse environment where my strong work ethic, education, and expertise can be used.
Overview
15
15
years of professional experience
Work History
Patient Care Coordinator
Elevance Health (Bioplus Specialty Pharmacy)
10.2023 - Current
- Enhanced patient satisfaction by efficiently scheduling appointments and managing patient flow.
- Streamlined communication between patients and healthcare providers, ensuring timely responses to inquiries and concerns.
- Assisted in the development of care plans tailored to individual patient needs, improving overall health outcomes.
- Coordinated with insurance companies for accurate billing and claim processing, reducing errors and financial discrepancies.
- Collaborated with interdisciplinary teams to create seamless transitions between various stages of treatment plans, enhancing continuity of care.
- Provided exceptional customer service by addressing concerns, answering questions, and ensuring patient satisfaction.
- Scheduled Specialty medications with referring provider offices, Customers, and nursing facilities.
Senior Fraud Specialist
Synchrony Financial, Resolution Services
09.2021 - 09.2023
- Handled large volume of inbound detection calls Reviewed individual transactions which appeared suspicious to uncover possible fraudulent activity.
- Resolved customer complaints by determining cause of problem, selecting best solution and expediting correction or adjustment.
- Collaborated closely with cross-functional departments to deliver high customer satisfaction.
- Performed account maintenance by closing out accounts and changing customer addresses.
- Monitored and verified suspicious activity on customer accounts.
- Processed applications for new accounts.
- Processed debit and credit card and electronic check payments. Boosted customer service satisfaction ratings through consistent quality control.
- Memorized scripts to achieve easy conversational flow in interactions with potential customers.
- Documented details of calls and customer interactions.
Claims Customer Care Representative
Lincoln Financial
03.2021 - 09.2021
- Answered questions and provided information regarding claim through the utilization of multiple applications and platforms. In addition, provided verification of benefits as needed for member or dental office.
- Directed incoming calls to internal personnel and departments, routing to best-qualified department.
- Documented customer contact to maintain record of customer interactions and elevate quality of service.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Communicated verification and authorization status updates to facilitate decision-making for patient insurance coverage.
- Maintained strong knowledge of basic dental terminology to better understand services and procedures.
- Provided education to the customer/employer regarding the product
- (primary products: dental and disability) while having a strong focus on attention to detail to ensure the claim/leave is notated appropriately Educated the customer on their claims needs/questions and advise of next steps in the process.
- Documented customer interactions and transactions for accurate, up-to-date records
Client Care Coordinator
United Healthcare
08.2020 - 10.2020
- Worked with clients to improve life choices and maximize benefits of programs.
- Educated potential participants on available services and processes to engage in program.
- Identified service gaps and located needed resources for individuals, including housing, work placement and other support.
- Determined need for special assessment activities for complex cases, effectively handling care plans.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
- Communicated verification and authorization status updates with members.
- Processed claims and appeals.
Patient Access Specialist/ Medical Records Clerk
Novant Maplewood Ave
01.2013 - 08.2020
- Performs registration and pre-registration functions for out-patients. Verifies insurance eligibility and discuss Advanced Beneficiary Notices (ABN) when appropriate. securing pre certifications.
- Obtain proper ICD10 codes for Medicare patients. Coordinates appointment scheduling and appointment reminder calls as needed.
- Collect payments for co-pays, deductibles, and other patient balances.
- Collect all demographic and financial information in an accurate and professional manner.
- Required technical expertise in all aspects of health care benefits including HMO's, PPO, as well as Medicare, Medicaid, and other local or State programs.
- Performs collection, processing, filing, maintenance, storage, retrieval, and distribution of medical records according to facility policies and procedures
- Maintain and controls the release of information to authorized persons only.
- Digitize film, print film and burn CD's for outside facility's. Professionally and courteously verified appointment times with patients.
Community Access Call Representative
Wake Forest Baptist Health
04.2015 - 04.2019
- Answer and manage incoming and outgoing calls while recording accurate messages.
- Arrange emergency air or ground patient transfers to the Medical Center from outside clinics and hospitals. Connect outside physicians to consult with a specific physician or a faculty physician in a specific specialty or subspecialty.
- Document and route incoming calls to nurse triage for physicians after hours, weekends and holidays services.
- Route general health questions from the general public to health on call nurses for advice.
- Activate teams for Telestrokes, Code Stemi's, Code stroke and Interventional Radiology.
- Connect Radiologist to ordering providers for stat radiology reports
Patient Scheduling Coordinator
Wake Forest Eye Center
02.2014 - 04.2015
- Worked as assistant to Chair of Ophthalmology Scheduled, checked out and canceled patient appointments according to visit types
- Opened and properly distributed incoming mail/forms.
- Organized documentation of prescription refill information.
- Scheduled surgeries for multiple surgeons and booked operating rooms.
- Located, checked in and pulled medical records for new patient appointments.
- Arranged referrals to other health care providers. Scheduled appointments for consultations, x-rays, lab tests, physical therapy, MRI's, CT scans, etc.
- Answered a constant flow of customer calls with several calls in queue per minute.
- Acquired copay assistant authorizations, and Veteran Affairs authorizations.
- Documented CPT ICD9 codes for insurance approval Rescheduled Doctors clinic on short notice for days Doctor is called away for meetings and vacations.
- Assisted in the maintenance of medical charts and/or electronic medical record (filing, Op Reports, test results, home care forms)
Medical Unit Secretary
Wake Forest Baptist Health (Pediatric ED)
01.2009 - 02.2014
- Contacted hospitals to confirm patients medical histories and prevent inaccurate diagnoses and treatments.
- Facilitated organized record retrieval and access by maintaining filing system for both in-house and discharged residents.
- Implemented radiology images for digitizing and organizing medical records.
- Greeted visitors and initiated triage processes for clients to streamline patient flow.
- Registered and verified patient records before triage with most up-to-date information.
- Answered telephone calls to offer office information, answer questions and direct calls to staff.
- Facilitated admissions from ED to inpatient.
Education
Bachelor of Science - Nursing
Winston Salem State University
Winston-Salem, NCCertification/Diploma - Medical Unit Secretary
Forsyth Technical Community College
Winston-salem, NC04.2008
High School Diploma -
Parkland High School
Winston-Salem, NC05.2005
Skills
- Patient Care Coordination
- Scheduling
- Computer Proficiency
- Appointment Scheduling
- Medical Data Collection
- Payment Collection
- Filing and Recordkeeping
- Patient Education
- Claims Processing
- HIPAA Compliance
- Insurance Verification
Timeline
Patient Care Coordinator
Elevance Health (Bioplus Specialty Pharmacy)
10.2023 - Current
Senior Fraud Specialist
Synchrony Financial, Resolution Services
09.2021 - 09.2023
Claims Customer Care Representative
Lincoln Financial
03.2021 - 09.2021
Client Care Coordinator
United Healthcare
08.2020 - 10.2020
Community Access Call Representative
Wake Forest Baptist Health
04.2015 - 04.2019
Patient Scheduling Coordinator
Wake Forest Eye Center
02.2014 - 04.2015
Patient Access Specialist/ Medical Records Clerk
Novant Maplewood Ave
01.2013 - 08.2020
Medical Unit Secretary
Wake Forest Baptist Health (Pediatric ED)
01.2009 - 02.2014
Bachelor of Science - Nursing
Winston Salem State University
Certification/Diploma - Medical Unit Secretary
Forsyth Technical Community College
High School Diploma -
Parkland High School
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