Twenty Years in Medical Business Management and Insurance
Overview
27
27
years of professional experience
Work History
Direct Care Worker
TEAM SELECT
02.2023 - Current
Utilization Management Review
ELEVANCE HEALTH
06.2019 - 06.2024
Medical Management Specialist
ANTHEM
11.2017 - 06.2019
Achieved NO PAST DATES! . . . a decrease of nine bed days—meaning these members are moving to appropriate levels of care
Compliance Licensing Specialist
KEY BENEFIT ADMINISTRATORS
08.2015 - 02.2017
Improved search-ability and accuracy by changing the way data is collected and stored.
Medical Management Coordinator
COOPERATIVE MANAGED CARE SERVICES
12.2007 - 07.2015
Began as Health Care Coordinator—advanced to Medical Management Coordinator.
Trained interns and billing staff and developed new processes for goal achievement.
Billing Specialist/Medical Assistant
COMMUNITY PHYSICIANS OF INDIANA
06.2005 - 02.2007
Insurance Collection Specialist, Team Leader
INDIANA HEART ASSOCIATES
04.1998 - 02.2005
Developed and implemented new hire and employee training programs.
Named key person during computer conversion.
Education
30 Hours -
MARKSON MANAGEMENT
Washington, DC
01.1988
Diploma - undefined
NORWOOD HIGH SCHOOL
Norwood, Ohio
01.1986
Medical Assistant Certification - undefined
SCARLET OAKS CAREER DEVELOPMENT
01.1986
Skills
ICD-9, CPT Coding
MS Office
Accounts Payable/Receivable
Indiana Health Guidelines
Analyzing Claims
Insurance Payer Fees
Prioritizing Patient Care
Authorizing Patient Service Requests
Tracking Collection Problems
CAQH Files
Patient and Family Education
Multitasking
Communication, Referrals, Discharge Planning
Identifying Potential Case Management Members
Collection Follow-up on Insurance Claims
Assisting Nurse in Research and Maintaining Census
Explaining Complex Rules, Laws, and Contracts
HIPPA
Computer Updates: Electronic Data Implementation
FDA, Medicare, and Medicaid Research
Resolving Issues Resulting in Claim Payments
Agent Licensing, Auditing, Tracking
OSHA
Section name
“Charlotte’s productivity remains among the highest of our performers on the team. She regularly seeks additional duties and opportunities to help achieve our departments goals.” –Rebecca Dobbins, RN, BSN, Manager 1, Inpatient Utilization Management, ANTHEM
“Charlotte proved herself to be an able employee, a diligent worker, and talented insurance representative. Her research was always thorough and comprehensive, and fact checking always accurate.” –Burlene Atkins, Manager, INDIANA HEART ASSOCIATES
“Charlotte is able to see the whole picture in relation to how physicians are contracted and various network affiliations. She understands how PPO networks, POS, and HMO plans work. She is a loyal addition, outgoing and known as someone to be counted on to follow through with task at hand.” –Judy Bourquin, Director, Provider Relations, INDIANA PROHEALTH NETWORK
Analytical, Detail Oriented with Track Record for Achieving Goals