Bridget Bush
Columbus,GA
Summary
Dynamic healthcare professional with extensive experience at Anthem Blue Cross and Blue Shield, excelling in performance quality analysis and operational leadership. Proven expertise in artificial intelligence validation and project management, coupled with strong training and facilitation skills. Adept at enhancing processes and ensuring compliance in complex systems.
Overview
33
33
years of professional experience
Work History
Scheduler
ST. Francis ENT
05.2024 - Current
- Schedule Surgeries, diagnostic procedures, eligibility checks and prior authorizations through many platforms Carelon, Availity, RadMD and Evicore
- Help checking in patients at the front desk and phones when needed
- Schedule in home sleep studies using Zoll through cloud Pat technologies
- Work on prior authorization appeals on denials
- Train new hires on Athena and Cerner
Performance Quality Analyst III
Anthem Blue Cross and Blue Shield (Elevance Health)
06.2018 - 10.2023
- Company Overview: 31 years in the Healthcare Insurance Industry
- Worked with different teams to provide information to make sure all information was coming over correctly from old systems to new systems
- Created Jira’s and met with IT and different areas on each side of the information to work to get everything moved without impact to our members
- Contract analysis to make sure the system was processing claims based on agreements and contracts
- Process improvement analysis making sure system was processing claims based off job aids and contracts
- Artificial intelligence claims processing analysis we validated that our AI was processing claims systematically without people intervention correctly and writing those up and meeting with IT and appropriate areas
- 31 years in the Healthcare Insurance Industry
Operations Expert (Lead)
Anthem Blue Cross and Blue Shield (Elevance Health)
06.2014 - 06.2018
- Company Overview: 31 years in the Healthcare Insurance Industry
- Finding customer’s expenses deductible, out of pockets and wellness credits via excel
- We created spreadsheets and looked at every claim to document and kept track of every claim that a person or provider submitted
- 31 years in the Healthcare Insurance Industry
Forklift Operator
Goody Products
02.1992 - 12.1992
- Pulled stock out of the back warehouse and placed in the picking lines, so orders could be pulled and boxed to be ticketed
- Once orders were packed and ticketed on pallets, ran UPS tracking and loaded them near the loading docks to be shipped
Education
High School Graduate -
Smith Station High School
Smiths Station, AL01.1991
ICD-9 and CPT Certificate -
Columbus Technical College
Skills
- Microfilm/data entry
- Training
- UAT testing
- CPT coding
- ICD-9 coding
- HCPCS coding
- Dental coding
- Revenue coding
- Microsoft Access
- Microsoft Word
- Microsoft PowerPoint
- Microsoft Excel
- Peoplesoft
- Operational expertise
- Mainframe systems
- Qcare
- WGS
- JIRA
- SSCR submissions
- Project leading
- Group facilitation
- Inventory management
- Performance quality review
- Artificial intelligence validation
- Migration projects
- Athena healthcare software
- Cerner healthcare software
Hobbies and Interests
- Cooking healthy lifestyle
- Travel
- Volunteering to help senior citizens
- Hiking
Timeline
Scheduler
ST. Francis ENT
05.2024 - Current
Performance Quality Analyst III
Anthem Blue Cross and Blue Shield (Elevance Health)
06.2018 - 10.2023
Operations Expert (Lead)
Anthem Blue Cross and Blue Shield (Elevance Health)
06.2014 - 06.2018
Forklift Operator
Goody Products
02.1992 - 12.1992
High School Graduate -
Smith Station High School
ICD-9 and CPT Certificate -
Columbus Technical College
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