Summary
Overview
Work History
Education
Skills
References
Accomplishments
References
Timeline
Generic

Catrinia Barnes

Pearl,MS

Summary

Dynamic healthcare professional with extensive experience at FinThrive, excelling in encounter data processing and compliance audits. Proven track record in reducing rejection rates through advanced Excel reporting and effective staff training. Skilled in Medicaid billing and denial management, fostering strong relationships with payers and providers to enhance operational efficiency.

Overview

11
11
years of professional experience

Work History

Associate Solution Advisor II | Encounter Data Analyst

FinThrive
05.2022 - Current
  • Manage relationships with 28+ MSOs (submitters), overseeing encounter data submissions and ensuring compliance with payer requirements.
  • Lead all payer and group onboarding initiatives, including testing, workflow design, and go-live support.
  • Conduct encounter file validation, COB accuracy checks, and batch audits to improve data quality and reduce rejection rates.
  • Analyze and monitor 837 transactions to identify rejection trends and implement corrective actions.
  • Develop and deliver weekly and monthly operational dashboards using advanced Excel macros and reporting automation, improving visibility into performance metrics.
  • Provide subject matter expertise and training to clients, providers, and internal teams on encounter data requirements and claim lifecycle best practices.
  • Collaborate with development and payer teams to test resubmission workflows, resolve discrepancies, and ensure successful balancing of Medicaid and Medicare encounters.

Team Lead · Medical Billing Specialist

TruBridge
02.2021 - 04.2022
  • Supervised billing staff responsible for high-volume claims processing for RHCs, hospitals, and ASC providers.
  • Oversaw claim submission, denial resolution, crossover billing, and payer follow-up to maximize reimbursement.
  • Improved Medicaid remittance workflows by implementing streamlined processes for dual-eligible claims.
  • Served as subject matter expert on billing platforms and trained new employees on claim lifecycle management.

Lead Medical Biller

Trilogy Healthcare Solutions
06.2019 - 01.2021
  • Maintained billing operations and optimized claim tracking systems, reducing delays in reimbursement.
  • Corrected claim errors and ensured timely submissions to Medicaid, Medicare, and commercial payers.
  • Conducted denial trend analysis and implemented corrective actions to reduce recurring issues.
  • Managed patient account adjustments and updates in EHR systems.

Precertification Specialist

Magnolia Health Plan
05.2018 - 05.2019
  • Verified eligibility, benefits, and processed prior authorization requests for Medicaid members.
  • Trained internal teams on claim routing workflows and denial resolution procedures.
  • Investigated provider concerns and ensured timely responses to authorization inquiries.

Insurance Claims Specialist

Morgan White Group
01.2016 - 06.2017
  • Handled claim resolution and payer follow-up across multiple insurance platforms.
  • Reconciled self-pay and insurance account discrepancies to ensure accurate data.
  • Supported patients and providers in resolving outstanding claim issues.

Claims Processor

American Public Life Insurance
04.2014 - 05.2016
  • Reviewed and adjudicated claims in accordance with policy guidelines.
  • Identified and corrected claim submission errors to ensure timely reimbursement.
  • Maintained strict HIPAA compliance when handling sensitive data.

Education

Associate of Applied Science - Healthcare Administration

Hinds Community College
01.2008

Skills

  • Encounter & Claims Data Processing (837/5010)
  • Medicaid/Medicare Billing & Reimbursement
  • Denial Management & Appeals Resolution
  • TR3 Data File Review & Compliance Audits
  • Crosswalk Analysis & COB Resolution
  • Payer, Provider & Clearinghouse Communication
  • Staff Training & Client Onboarding
  • EMR & Billing Platforms: Epic, AdvancedMD, Thrive, ClearIQ
  • Excel Dashboards & Macros for Reporting

References

Available upon request

Accomplishments

  • I have been employer of the month and quarter a few times.

References

References available upon request.

Timeline

Associate Solution Advisor II | Encounter Data Analyst

FinThrive
05.2022 - Current

Team Lead · Medical Billing Specialist

TruBridge
02.2021 - 04.2022

Lead Medical Biller

Trilogy Healthcare Solutions
06.2019 - 01.2021

Precertification Specialist

Magnolia Health Plan
05.2018 - 05.2019

Insurance Claims Specialist

Morgan White Group
01.2016 - 06.2017

Claims Processor

American Public Life Insurance
04.2014 - 05.2016

Associate of Applied Science - Healthcare Administration

Hinds Community College

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