Carla Brown

• Weekly meeting with Manager to review initiatives, accomplishments, and any identified risks, including potential coaching/corrective action related to performance.
• Weekly Touchpoints with Denial Specialist to discuss trending issues, productivity challenges, quality of work, Ways for improvement - if needed.
• Scheduling Team Calendars For Peer PTO – Meetings – Coverages for Peer PTO, Additional Training – (When Needed)
• Weekly Team Huddles to discuss trending issues, updates, questions, concerns – team building games – when time permits.
• Complete monthly quality audits for team members and update team member productivity & accuracy scores and hours worked.
• Completing Payor Escalation Files monthly for Government Team Payors for Provider Representative Review (to include – Humana/CarePlus/WellCare-Centene Product Line – Military Payors)
• Attendance of Meetings as requested ( JOC, CBO Touchpoints, Director Touchpoint, Monthly Payor Specific Meetings)

2008 – 2019 Billing Rev Cycle /RAD Specialist/Refund Specialist - Denials Management Specialist

· Billing of all secondary & tertiary claims

· Compiling Daily Claims Summary - Identifying the cause of claim denial.

· Coordinating Medical Necessity Appeals with Clinical Team

· Writing of Technical Appeals & Follow Up of Claims Status

· Audit, Appeals & Denials Management

· Billing Specialist for All Government & Non - Government Insurance Claims

· Ensuring that claims met Hospital Ethic & Compliance Guidelines, as well as Correct Coding Initiatives & Limits of Quantity for MUE (Medical Units)

• Office Manager For Daily Operations
• Jr. Buyer for Production & Non-Production Supplies
• Negotiated Pricing/Contracts with Vendors/Supplier
• Balanced Departmental spending/budget.
• Created requisitions for all departments, as well as invoicing.
• Tracked Absences- Time Card Submission and Submitted Payroll for Office Staff employees.