Brittany Jordan
Oklahoma City,OK
There is a powerful driving force inside every human being that, once unleashed, can make any vision, dream, or desire a reality.
Tony Robbins
Summary
High achiever, highly motivated professional eager to lend combined knowledge and skills to enhance business performance. Leveraging seasoned work ethic to quickly adapt to different processes individually or team capacities to drive company objectives with a 99.95% quality. Resourceful and results-driven with a passion for professional growth and efficiency to meet company needs and increase service value.
Overview
9
9
years of professional experience
Work History
Appeal Specialist II Team Lead (Hybrid)
Blue Cross Blue Shield
01.2019 - Current
- Evaluated multiple sources of information such as CPT, ICD-10, HCPS, medical policy documents, member's benefits and claim processed evidence-based guidelines to support appeal decisions
- Delegated tasks to team members accordingly and supervised daily work of staff to ensure work prioritization, when need be and ran daily self-pend reports
- Presented at meetings related to appeals processes, results, trends and helped on appeal knowledge with peers to ensure accurate information
- Researched medical records to ensure accuracy of claims processing and compliance with regulations and make sure it's not fraud, waste, or abuse
- Analyzed clinical data, healthcare coding and complex situations quickly and accurately while utilizing strong problem-solving skills
- Facilitated communication between providers, members and other parties involved in appeals process and inquires via telephone, mail, or email
- Collaborating with other departments ensuring timely resolution per established deadlines for appeals and projects.
- Maintained thorough understanding of federal, state, and local regulations pertaining to healthcare, ensuring compliance across all cases handled
- Demonstrated adaptability in handling diverse caseloads, including medical necessity denials, coding disputes, authorization issues, and benefit determinations.
- Acted as reliable resource for colleagues in need of assistance or guidance on complex cases, fostering collaborative and supportive work environment
Revenue Cycle Specialist
Saint Francis Health System
01.2017 - 02.2018
- Managed over 100 patient accounts, including billing
- Monitored changes in healthcare regulations and policies that impact revenue cycle process
- Utilized data analytics to identify trends in denials and underpayments
- Tracked unpaid claims to ensure timely submission of appeals when necessary
- Ensured compliance with HIPAA regulations governing patient privacy rights
- Worked closely with other departments such as clinical services and finance to ensure proper coordination of care throughout entire revenue cycle process
- Reconciled discrepancies between invoices received from providers and payments received from third-party payers
Medical Billing Specialist
Integris
Oklahoma City, OK
06.2015 - 02.2017
- Self-motivated, with a strong sense of personal responsibility.
- Worked effectively in fast-paced environments.
- Answered 100 calls per day exceeding quota by 10%
- Provided prompt customer support with a professional, friendly, and patient attitude
- Trained new employees on systems and company polices
- Responsible for cash posting, billing, collecting, and charge entry, with the use of multiple systems
- Passionate about learning and committed to continual improvement.
- Utilized electronic billing systems to submit claims to insurance providers in a timely manner.
- Negotiated payment arrangements with delinquent accounts in order to collect
outstanding balances.
Education
Certificate - Medical Billing And Coding
05.2013
Skills
- Verbal and written communication skills
- Patient relations
- Critical thinking and problem solving
- Microsoft Office
- Sales force
- Accounts receivable and reconciliation
- Workflow delegation
- Time management
- Detail oriented
- Multi-tasking
- Leadership skills
- Adaptability
Career Highlight
Team lead in my group of performance guarantee appeals team
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Appeal Specialist II Team Lead (Hybrid) - Blue Cross Blue Shield
01.2019 - Current
Revenue Cycle Specialist - Saint Francis Health System
01.2017 - 02.2018
Medical Billing Specialist - Integris
06.2015 - 02.2017
Wright Career College - Certificate, Medical Billing And Coding
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