DANA Glissen-Burton
SAULSBURY,TN
Summary
Proactive Billing and Quality Manager with over a decade of experience in healthcare billing and quality management. Skilled in claims processing and patient eligibility verification, with a strong commitment to continuous improvement and compliance with industry regulations.
Overview
13
13
years of professional experience
Work History
Billing and Quailty Manager-LPN
HCCHC
Bolivar, Tn
06.2012 - Current
- Led team meetings to discuss project updates and operational strategies.
- Processed medical claims accurately using billing software systems.
- Reviewed patient records to ensure correct coding and documentation.
- Communicated with healthcare providers to resolve billing inquiries promptly.
- Maintained up-to-date knowledge of healthcare regulations and coding guidelines.
- Collaborated with insurance companies to verify patient eligibility and coverage.
- Conducted audits of billing practices to identify discrepancies and improve accuracy.
- Ensured timely filing of all claims within established guidelines.
- Filed and submitted insurance claims.
- Submitted claims to insurance companies electronically or by mail.
- Maintained current CPT, HCPCS codes library as well as ICD-9, 10 CM diagnostic codes.
- Processed corrections and adjustments as needed to ensure accurate payment from third party payers.
- Monitored aging accounts receivable report weekly to identify unpaid balances due.
- Expertly assigned charges and payments for medical procedures.
- Interpreted physician orders, notes, lab results, radiology reports. for appropriate code assignment.
- Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules.
- Led quality assurance initiatives across multiple departments to ensure compliance.
- Conducted regular audits of processes to identify areas for improvement.
- Facilitated cross-functional meetings to address quality-related issues and solutions.
- Managed documentation and reporting of quality metrics and compliance standards.
- Developed and implemented quality management systems to ensure compliance with customer requirements.
- Provided leadership in developing best practices for continuous improvement initiatives across all departments.
Education
Certified Coder And Biller - Coding And Billing
ArcoPro Coding And Billing
GA10-2024
LPN - Nursing
Tennessee Technological University
Whiteville, TN08-2003
Skills
- Medical coding
- Claims processing
- Billing software
- Healthcare compliance
- Quality management
- Patient eligibility verification
- Team leadership
- Problem solving
- Time management
- Complex Problem-solving
Timeline
Billing and Quailty Manager-LPN
HCCHC
06.2012 - Current
Certified Coder And Biller - Coding And Billing
ArcoPro Coding And Billing
LPN - Nursing
Tennessee Technological University