Charnissa Franklin
Spring,TX
Summary
Experienced and enthusiastic Consultant with track record of success across wide range of industries. Possesses exceptional interpersonal, problem-solving and analytical skills to provide advice and expertise to client organizations improving business performance. Experienced in all aspects of operations, strategy and finance.
Overview
13
13
years of professional experience
1
1
Certification
Work History
EMR Implementation Consultant/Analyst Credentialed Trainer /Biller
Frasier Healthcare
06.2022 - 06.2024
- Provided IT support with systems training, conversions and go-live in Ambulatory, Cadence, Prelude, RTE, ASAP, Prelude, Grand Central, HB/PB, HIM, Radiant, Willow, Care Everywhere, Beaker and ClinDoc
- Assisted staff with progress notes, registration and scheduling, order entry, vitals and system assessments
- Developed, implemented and managed Epic applications for healthcare organizations
- Performed data analysis and troubleshooting to resolve Epic issues
- Developed and implemented solutions based on Epic framework that met client needs
- Provided technical support and guidance to users
- Assisted with Epic upgrades and data migrations
- Troubleshooted workflow related issues and redirected high priority to Pegasus
- Installed and tested software upgrade, and maintained software applications
- Applied/re-applied/reversed adjustments and transactions due to billing errors
- Worked with the Chargemaster which entails building charges for the hospital
- Also met with departments with concerns they may have regarding charge builds and changes that may occur in the descriptions of their charge builds
- Reviewed accounts receivable on a daily basis and performed follow-up on delinquent accounts, according to established policies and procedures, including but not limited to: addressing outstanding receivables, short payments, split bills, over payments, clear claim edits, billing, and denials, credentialing, coding, and reviewing for accuracy and payer requirements (i.e rates, authorizations, correct pay source, and billing codes)
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses
- Verified accuracy of documentation such as Medical Records, Procedures, Medical Coverage and Date of Service to ensure a correct claim is sent and prompt payment from payers
- Recommended departmental/agency corrective action as required
- Performed appropriate hospital billing functions, including manual re-bills as well as electronic submission to payers using the Athena system and Epic system.
Certified Cerner Trainer Specialist II/Adoption Coach/Conversion Specialist
FTIC/ATG
01.2022 - 03.2024
- Cerner EHR Activation and Instructor Led Training (ILT) for Veterans Affairs (VA)
- Delivered classroom Instructor Led Training (ILT) for Patient Accounting
- Provided one-on-one and Over-the-Shoulder (OTS) training; provided ongoing support using Revenue Cycle, MPages, Clinical Documentation, Iview, CPOE/Quick Orders, Message Center, and PowerChart
- Attended meetings, conference calls and briefings as directed by the Government Site Lead; Coordinate and/or performed administrative functions necessary to deliver and document training programs
- Trained and supported physicians and nurses in both outpatient and inpatient clinics
- Engaged in training End-Users for specific role functionality and workflows
- Worked with Coding Departments, Registration areas and Information Technology Services to ensure proper setup of new service line charging, coding, and billing, as well as appropriate flow of charts for coding.
Revenue Cycle Claims Resolution Specialist
Expeditive
08.2015 - 01.2022
- A/R Follow-up and cleanup for 7+ years, fine-tuning accounts to a zero balance
- Posted daily deposits, balanced and ran monthly cash reports including A/R Aged Balance, A/R Detail and monthly billing reports
- Perform and assist other team members in the analysis, design, configuration, testing and maintenance functions
- Maintain accurate input and update of chart deficiencies into the computer system
- Assist product teams in development of design and required documentation
- Oversee the activities of billing facility claims to various payers for the hospital
- Build, test and support the Grand Central application implementation that focuses on facility structure and patient flow throughout the hospital
- Collaborate with Grand Central Principle Trainer for educational needs
- Collaborate and coordinate with other analyst teams for implementation and Go-Live
- Utilized cloud-based applications like Freshdesk, Stripe, Office 365, and G-Suite
- Ensured proper and timely submission of all patient accounts released for billing by the HIM dept
- This includes the responsibility for preparation and processing of primary and secondary claims identification and correction of errors, re submission and appeal of denials, transmission of electronic claims and distribution of paper claims
- This will include working the lifespan of the claims from production to account resolution
- Researched and verified employment for the purpose of garnishments, judgments or wage attachments in the General District Court
- Payment posting and processing as well as posting charges and performing adjustments
- Processed claim referrals, new claim hand offs and requests regarding litigation
Revenue Cycle/AR Specialist
WAYNE PERRY & ASSOCIATES
07.2014 - 08.2015
- Edited claims to meet and satisfy hospital billing compliance guidelines for electronic submission
- Examined patients insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under their policies when applicable
- Monitored aging reports and take such steps as necessary to guarantee payment of claims
- Anticipated insurance trends and advised Supervisor of changes
- Data entry of daily transactions, charge tickets, insurance payments, patient payments, diagnosis codes
- Worked daily with numerous insurance companies including Medicaid, Medicare, Aetna, Humana, United Healthcare, Tricare and many other companies
- Abstracted all necessary information and assigned codes (ICD-9, CPT & HCPCS), which most accurately describe each documented diagnosis, surgical procedure and special therapy or procedure according to established guidelines
- Appropriately and correctly identified errors and re-led denied/rejected claims as they were received from the Patient.
Provider Relations Representative
Aetna
06.2011 - 06.2014
- Performed review of member claim history to ensure accurate tracking of benefit maximums and /or coinsurance/deductible, along with reworks and payments rendered
- Provider Relations served as liaison between the insurance company and customers to explain coverage terms and answered questions
- Utilized policy, procedure, and professional experience to effectively respond to questions regarding contracting, fee schedules, claims payments, co-pay structures, and plan types
- Answered questions, concerns, issues that dealt with benefits, complaints, close and re-open practice, orientation and regarding education, policies and procedures, member or provider appeals, removing members from provider panel, request for referral forms, claim status, and claim adjustments.
Education
Bachelor of Science in Healthcare Administration -
West Coast University-Dallas
Dallas, TX06.2023
Bachelor of Science in Healthcare Management -
Tiffin University
Toledo, OH11.2013
Skills
- Documentation
- Compliance
- Denial
- Reconciling
- Accuracy
- Team Player
- Analysis
- Organizational skills
- CPT Coding
- ICD-9
- ICD-10
- EMR Systems
- Epic
- Medical Coding
- IT Support
- Medical Records
- Software Testing
- Hospital Experience
- Insurance Verification
- Business Analysis
- HIPAA
- Medical Terminology
- Medical Scheduling
- Healthcare Management
- Technical Support
- Athenahealth
- Order Entry
- Experience Administering Injections
- Medical Billing
- Medical Office Experience
- Agile
- Documentation Review
- Pharmacy Software
- Cerner
- Scrum
- Python
- Meditech
- Microsoft Word
- Microsoft Office
- Microsoft Excel
- Microsoft Access
- SQL
- Microsoft SQL Server
- Jira
- Java
- Visual Basic
- Linux
- Software Development
- XML
- Systems Analysis
- Interpersonal skills
- JavaScript
- Attention to Detail
- Problem-Solving
- Team Leadership & Development
- Client Relationships
- Analytical Thinking
- Project Implementation
- Analysis & Evaluation
- Best Practices Implementation
- Operations Analysis
- Data Analytics
- Project Analysis
- HTML
- MySQL
- NET Framework
- Data Analysis
- Quantitative skills
- Teamwork and Collaboration
Certification
- Cerner Patient Accounting
- Certified Phlebotomy Technician
- CCA Data Analyst
- System Analysis
- Programming Basics
Timeline
EMR Implementation Consultant/Analyst Credentialed Trainer /Biller
Frasier Healthcare
06.2022 - 06.2024
Certified Cerner Trainer Specialist II/Adoption Coach/Conversion Specialist
FTIC/ATG
01.2022 - 03.2024
Revenue Cycle Claims Resolution Specialist
Expeditive
08.2015 - 01.2022
Revenue Cycle/AR Specialist
WAYNE PERRY & ASSOCIATES
07.2014 - 08.2015
Provider Relations Representative
Aetna
06.2011 - 06.2014
Bachelor of Science in Healthcare Administration -
West Coast University-Dallas
Bachelor of Science in Healthcare Management -
Tiffin University
- Cerner Patient Accounting
- Certified Phlebotomy Technician
- CCA Data Analyst
- System Analysis
- Programming Basics
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