CANDICE BREWER
MCDONOUGH,GA
Summary
Supervisor with 18 years of exceptional experience in all areas of the Revenue Cycle. Creative and motivated leader adept at utilizing design and planning strengths to accomplish complex projects. Skilled in teaching new concepts and best practice strategies.
Overview
19
19
years of professional experience
Work History
Billing Supervisor
ROMTech
10.2020 - Current
- Assess current revenue cycle procedures and implement improvements to foster efficiency.
- Oversee daily operations for Patient Access, Prior Authorization, Claims, and A/R teams.
- Complete financial reporting and analysis for billing revenue cycle.
- Develops strategic plans for day-to-day financial operations.
- Create and Implement standard operating procedures for the full Revenue Cycle Team.
- Provide prior authorization support for physicians, healthcare providers, and patients in accordance with payer guidelines.
- Evaluate clinical criteria for approval or denial of services requiring prior-authorization.
- Research denied claims and contact insurance companies to resolve these issues.
- Train and mentor staff on procedures, compliance requirements, and collections techniques.
- Conduct performance reviews and implement successful performance improvement plans.
- Support the financial director with special projects and additional job duties.
- Complete all PTO and Payroll Requests for the teams.
- Fully implement and maintain 3rd party vendors in multiple areas of the department.
- Work closely with other billing organizations to maintain a positive relationship between both companies.
- Ensure the teams are exceeding daily and monthly work volume requirements.
- Multi-tasking and navigating multiple systems to include BrightTree, DrChrono, Advanced MD, clickup, UKG, Just Works, Ring Central, and Microsoft Teams
Medical Billing Representative
Southeastern Lung Care
06.2005 - 10.2020
- Initiated and followed up on appeals.
- Helped patients better understand their statements and EOBS.
- Posted and allocated collections payments.
- Entered insurance and demographic information into the system for inpatient hospital claims to be processed.
- Worked closely with on call physicians to accurately enter hospital charges.
- Monitored billing tasks daily
- Managed patient budget agreements to set recurring payments.
- Managed accounts being sent to a 3rd party collections company.
- Completed reports, special projects, and any task assigned by the Billing Manager
- Performed daily and month end close reconciliation for 4 office locations.
- Posted Electronic and paper insurance payments.
- Worked closely with HCPCS and ICD 10 codes to ensure claims are processed correctly.
- Traveled to perform new hire training at all company locations.
- Reviewed clinicals and performed coding for Pulmonary procedures, Inpatient Critical Care, and E/M visits for all locations.
- Reviewed patient charts to better understand health histories, diagnosis, and treatments.
- Generated reports to identify coding trends and discrepancies.
- Navigated Medical Manager, Intergy Greenway, and EPIC systems.
Education
CPC Certification - Medical Billing And Coding
Chronicles Billing Inc.
07.2019
High School Diploma -
Newton County High School
Covington, GA01.2005
Skills
- CPC
- Medical Billing/Coding
- DME/Critical Care/Pulmonary
- Medical Terminology
- Staff Management
- Process Monitoring and Improvement
Timeline
Billing Supervisor
ROMTech
10.2020 - Current
Medical Billing Representative
Southeastern Lung Care
06.2005 - 10.2020
CPC Certification - Medical Billing And Coding
Chronicles Billing Inc.
High School Diploma -
Newton County High School
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