Brittany Gilbert
Denham Springs,Louisiana
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
13
13
years of professional experience
Work History
Senior Claims Analyst
Lifepoint Health
Columbus, GA
07.2022 - 10.2024
- Reviewed medical claims for accuracy and completeness, verifying patient eligibility and coding.
- Ensured compliance with insurance company policies and procedures related to the processing of claims.
- Research, identify, and obtain data/information needed to help process claims or resolve claim issues.
- Investigated discrepancies in medical billing information such as incorrect codes or amounts due.
- Researched claim denials and appeals to determine appropriate resolution.
- Assessed medical records for coverage eligibility and benefit accuracy.
- Developed strategies for resolving complex claims issues.
- Submitted electronic claims through various clearinghouses when necessary.
- File claims using all appropriate forms and attachments.
Billing Specialist
The Hospice of Baton Rouge
Baton Rouge, LA
01.2020 - 06.2022
- Reviewed medical records to ensure accuracy of billing information and patient data.
- Prepared itemized statements, bills, or invoices and recorded amounts due for items purchased or services rendered.
- Verified insurance coverage and identified third-party payers for billing purposes.
- Monitored accounts receivable activity to ensure timely payment of invoices.
- Answered customer inquiries regarding billings, payments, account status.
- Submitted claims to insurance companies.
- Checked claims coding for accuracy with ICD-10 standards.
- Answered incoming calls regarding billing inquiries from patients and and or providers in a professional manner.
Claims Representative
Blue Cross and Blue Shield
Baton Rouge, Louisiana
04.2015 - 12.2019
- Reviewed and verified insurance policy information to assess coverage and determine appropriate claims processing procedures.
- Processed a high volume of incoming claims in accordance with established policies and procedures.
- Adhered to all applicable laws, regulations, and company standards while processing claims.
- Applied knowledge of coding systems such as CPT-4 and HCPCS codes for proper reimbursement.
- Coordinated benefits with medical insurance plans and Medicare providers.
Medical Office Manager
HealthCare First
Grosse Tete, Louisiana
08.2011 - 03.2015
- Developed and implemented a new filing system for medical records, resulting in improved patient care.
- Created and maintained office policies and procedures to ensure smooth operations and compliance with all state regulations.
- Coordinated with insurance companies to verify coverage of services rendered.
- Maintained accurate patient data, including medical history, laboratory results, billing information and other relevant documents.
- Scheduled appointments for patients in accordance with their individual needs and preferences.
- Managed accounts receivable for the practice, ensuring timely payments from insurance companies and patients.
- Trained new staff on office procedures, software programs and customer service protocols.
- Provided support to physicians by organizing patient charts prior to scheduled appointments.
- Handled telephone inquiries from patients regarding appointment scheduling or general questions about the practice's services.
- Monitored inventory levels of supplies necessary for daily operations of the office.
- Reviewed employee time sheets for accuracy before submitting them for payroll processing.
- Oversaw day-to-day operations of the front desk area to ensure efficient flow of patients through check-in and checkout processes.
Education
High School Diploma -
North Iberville High
Rosedale, La05-2002
Some College (No Degree) - Accounting
Baton Rouge Community College
Baton Rouge, LASkills
- 3 years with CSP Facets
- 15 years claims processing
- 5 claims adjustment
- Knowledge of ICD-9, ICD-10 and HCPCS codes
- Experience with CMS- 1500 and UB-04 forms
- Microsoft Office (Word, Outlook, Excel, Teams, PowerPoint)
- Complaint with HIPPA regulations
- Typing speed 60 WPM
Timeline
Senior Claims Analyst
Lifepoint Health
07.2022 - 10.2024
Billing Specialist
The Hospice of Baton Rouge
01.2020 - 06.2022
Claims Representative
Blue Cross and Blue Shield
04.2015 - 12.2019
Medical Office Manager
HealthCare First
08.2011 - 03.2015
High School Diploma -
North Iberville High
Some College (No Degree) - Accounting
Baton Rouge Community College
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