Summary
Overview
Work History
Education
Skills
Accomplishments
Certifications Awards
References
Timeline
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Brenda Taylor

Summary

Hardworking, highly motivated professional eager to lend combined knowledge and skills to enhance business performance. Operates well in both individual and team capacities, leveraging seasoned work ethic to quickly adapt to different processes and drive company objectives. Resourceful and results-driven with a passion for growth and efficiency to meet company needs and increase service value.

Overview

16
16
years of professional experience

Work History

SPAP Sr. Eligibility & Billing Analyst

UnitedHealthcare
04.2023 - Current
  • Maintained strict confidentiality with all personal data as per company guidelines.
  • Maintained up-to-date knowledge of industry regulations, ensuring compliance in all aspects of the billing process.
  • Enhanced customer satisfaction with timely and accurate billing information, resolving disputes promptly and professionally.
  • Maintained eligibility and benefits for SPAP (State Pharmaceutical Assistance Program)
  • Managed customer relationships effectively, addressing concerns promptly and professionally to ensure continued business partnerships.
  • Adhere to metrics and quality guidelines. Meet and often exceeded expectations.

Sr. Billing Analyst -Employer Group Subsidized Billing

UnitedhealthCare
10.2022 - Current
  • As a Billing Analyst for the EGB department I was responsible for a select amount of groups
  • Each month I would create and send my groups monthly invoices either sent email or uploaded into the a eService system
  • A few of my groups are reconciliations, meaning they were not billed as paid groups
  • Each month they will send me their payment detail and I would have go through it and work the members matching up what we have in our GPS system
  • Once this was done there would be members that had retro dates with either owed or credited amounts that I then had to create an Excel sheet, with this information which is known as a Discrepancy letter
  • This letter then was sent to my group for review
  • Also, throughout the month I would be assigned member refunds that had to be done in a timely manner
  • We also had Softcalls throughout the month that if one of our groups was late on a payment and had six months of late payments
  • We had to place a call or email obtaining the payment detail
  • If I had any downtime, I would reach out to our SMEs and if they had any projects that they needed help on I would assist with that
  • Would also post on our SharePoint if I had free time, to help my fellow colleagues.

Admin Assistant for 504/ARDs

Canyon High School
08.2021 - 09.2022
  • As the Admin Assist for 504/ARDs, I was responsible for contacting the parents of our Special Needs/504 students to schedule their annual ARDs/504 meetings
  • I also emailed and mailed out the notice
  • All this had to be done in a timely manner to be compliant
  • Made sure all staff that needed to attend received an emailed invite
  • I also helped all our case managers with anything they needed done-calling parent, sending documentation to the students, supplies and organizing their days off on our calendar
  • I also made sure the ARD meeting room was clean and organized for all staff.

Burn Ambassador/Child-watch

Burn Boot Camp
03.2020 - 06.2021
  • As a BA for Burn Boot Camp, I am responsible for running the front desk
  • This includes welcoming each member as they arrive to camp and checking them in
  • Making sure all members are current on waivers and memberships for the gym
  • Checking email, handling phone calls, text messages etc
  • When new trails arrive, we are responsible for selling new memberships, introducing them to the trainers, giving a tour and asking for any medical conditions
  • This also includes cleaning and any low maintenance to the gym, restocking and selling of retail
  • Our Child-watch room is where members drop off the kiddos for our 45 min camps
  • Each of us are trained in CPR and First-Aid.

EDI Coordinator

Colorado Health Medical Group
05.2014 - 08.2016
  • As the EDI Coordinator I am responsible for updating records, specifications, and operating procedures of partner systems
  • As well as coordinate with trading partners to maintain effective EDI relationships and provide support to all internal departments and vendors
  • I provide technical support to all EDI application and monitor all inquiries for enrollment and payments
  • I administer all receiving and sending of all EDI documents and perform troubleshoot on all processes to resolve all content issues and map problems
  • I am also responsible for assigning website access for the business office along with other departments.

Clinic Billing/Insurance Specialist

Colorado Health Medical Group
07.2010 - 05.2014
  • As a Billing/Insurance specialist I am responsible for researching Medicare claims ex: Prepared billing correspondence and maintained database to organize billing information
  • Compiled and tracked outstanding balances owed to medical facilities
  • Updated patient financial information to guarantee accuracy
  • Examined patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under their policies when applicable
  • Confidently and adeptly handled claim denials and/or appeals
  • Identified and resolved patient billing and payment issues posted and adjusted payments from insurance companies
  • Currently I am the Super User for the billing department with our new Practice Management System, EPIC.

Insurance Specialist

Greeley Medical Clinic
10.2008 - 07.2010
  • As a Billing/Insurance specialist I am responsible for researching Medicare claims ex: Prepared billing correspondence and maintained database to organize billing information
  • Compiled and tracked outstanding balances owed to medical facilities
  • Updated patient financial information to guarantee accuracy
  • Examined patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under their policies when applicable
  • Confidently and adeptly handled claim denials and/or appeals
  • Identified and resolved patient billing and payment issues posted and adjusted payments from insurance companies.

Education

Medical Billing and Coding -

Career Coders LLC - Loveland, CO
01.2008

Cosmetology -

Hair Dynamics - Fort Collins, CO
01.2005

High School Diploma -

Larimer County High School DP - Loveland, CO
01.2002

Skills

  • Excellent verbal communication
  • Adept multi-task
  • Close attention to detail
  • Resourceful and reliable worker
  • Excellent problem solver
  • Composed and professional demeanor
  • Fast Learner
  • All Microsoft Programs,
  • EDI knowledge
  • GPS
  • Simon
  • Macros
  • ORBIT
  • Oscar
  • ART
  • CMS
  • PeopleSoft
  • Invoice Generation
  • Financial Reporting
  • Patient account management
  • HIPAA Compliance
  • Payment Transactions
  • Billing and Invoicing

Accomplishments

    Several Bravo's

    Quarterly QVC earned

Certifications Awards

  • Medical Billing and Coding
  • Novitas Solutions-Medicare
  • Trailblazer-Medicare
  • Ship-Shape Award- being recognized for my engagement in the Medicare process and LEAN.
  • Team Care Awards- from 2009 to 2012

References

  • Jessica Lewandowski, Co-worker, EGB & SPAP Departments for UnitedHealthcare, (763) 292-6371
  • Jas Jackson, Co-worker, SPAP Department for UnitedHealthcare, (602) 505-3113
  • JoDee Meyers, Supervisor, Lead Special Education Specialist for Canyon High School, (830) 221-2487

Timeline

SPAP Sr. Eligibility & Billing Analyst

UnitedHealthcare
04.2023 - Current

Sr. Billing Analyst -Employer Group Subsidized Billing

UnitedhealthCare
10.2022 - Current

Admin Assistant for 504/ARDs

Canyon High School
08.2021 - 09.2022

Burn Ambassador/Child-watch

Burn Boot Camp
03.2020 - 06.2021

EDI Coordinator

Colorado Health Medical Group
05.2014 - 08.2016

Clinic Billing/Insurance Specialist

Colorado Health Medical Group
07.2010 - 05.2014

Insurance Specialist

Greeley Medical Clinic
10.2008 - 07.2010

Medical Billing and Coding -

Career Coders LLC - Loveland, CO

Cosmetology -

Hair Dynamics - Fort Collins, CO

High School Diploma -

Larimer County High School DP - Loveland, CO

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Brenda Taylor