Brittany Barren
Las Vegas,NV
Summary
With over 10 years of experience in healthcare services and the cosmetology field, I have developed a diverse skill set in performing health services activities and overseeing patient management functions. I excel in effective leadership, fostering teamwork, and maintaining high morale. My strengths lie in problem-solving, multitasking, and prioritizing tasks in fast-paced, high-stress environments where attention to detail and meeting deadlines within changing priorities are crucial. Additionally, I possess advanced skills in typing at a speed of 45 words per minute and 10-key operations.
Overview
9
9
years of professional experience
Work History
Member Service Representative
Providence Medicare Advantage Health Plan
07.2022 - Current
- Advise and resolve customer needs with empathy and efficiency during each interaction.
- Assist with medical and pharmacy inquiries from members, providers, and pharmacy representatives according to HIPAA guidelines.
- Billing, Claims and Prior Authorization specialist, logged and submit complaints .
- Surpassed performance goals in efficiency, call quality, customer satisfaction, first call resolution, adherence, and attendance.
Member Service Representative
Anthem Blue Cross Blue Shield
07.2018 - 07.2022
- Follow- up and collection outstanding aged trial balance reports, including but not limited to oral and written communications
- Prepare and edit medical claims for submission, both hardcopy and electronically, to various 3rd party payers and clearing houses
- Batch and deposit preparation of daily payments received
- Post payments and contractual adjustment to the patient accounts in the practice management system
- Review and process the daily correspondence to correct or update inquiries from insurance carriers
- Send out ID cards requested by patient, update, reprocess claims, submit appeals, obtain insurance authorizations as required by insurance plan, documenting authorization numbers in the appropriate fields for accurate billing
- Responsible for expediting the administrative requirements for patient referrals are made to participating providers, to and from the patient's health plan
- Acts as a resource regarding referrals, authorizations, one day grievances, and insurance plan guidelines
- Very knowledgeable of HCPCS/CPT codes, HMO, PPO, PFFS, POS, EPO, MEDICARE and MEDICAID plans
Customer Care/ Claims Reconciliation Specialist
Humana Insurance Company
08.2015 - 07.2018
- Operate the state of the arts of the call center to conduct great customer service for Humana members
- Responsible for providing accurate information in meeting Quality expectations while using excellent verbal skills, and CAS, CRM, CCP, CI, CRM, HOD, HCPCS/CPT CODES and ARGUS system to conduct accurate research and information to provide customers accurate help while active engaging with members with no time structure in a workplace professional atmosphere
- And very knowledgeable of various HMO, PPO, PFFS, POS, MEDICARE and MEDICAID plans
Education
High School Diploma -
Desert Rose High School
LV, NVCosmetology -
Euphoria Institute
LV, NVSkills
- Customer service
- Relationship building
- Financial transactions
- Customer support
- Call center experience
- Escalation handling
- Complaint handling
References
Excellent references available upon request.
Timeline
Member Service Representative
Providence Medicare Advantage Health Plan
07.2022 - Current
Member Service Representative
Anthem Blue Cross Blue Shield
07.2018 - 07.2022
Customer Care/ Claims Reconciliation Specialist
Humana Insurance Company
08.2015 - 07.2018
High School Diploma -
Desert Rose High School
Cosmetology -
Euphoria Institute
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