Danita Brown
Florence,SC
Overview
12
12
years of professional experience
Work History
Provider Enrollment Analyst
Palmetto BCBS
04.2022 - Current
- Review, research, analyze, and process provider enrollment applications.
- Notified insurance agents and accounting departments of policy cancellations and changes.
- Ensures provider file integrity and that suppliers are in compliance with established standards and guidelines.
- Obtains information from internal department, providers, government and/or private agencies.
- Provides in-depth review and verification/validation of provider data; verifies provider data by use of information databases and various organizations/agencies to ensure authenticity.
Eligibility Worker
South Carolina Department of Health and Human Services
11.2018 - 03.2021
- Collect and accurately prepare case files and client history information; enter data and prepare reports
- Conduct client interviews to clarify information
- Assist clients in verifying information
- Complete forms to render case decisions using federal and state regulations (Medicaid policies and procedures)
- Provide external customer support by answering and/or returning phone calls and voicemail daily
Claims Customer Service Advocate II
Blue Cross Blue Shield of South Carolina
02.2013 - 11.2018
- High volume call center for military service members and providers regarding Tricare insurance claims
- Researched, Bill and/or Rebilled rejected health insurance claims for payment and/or reimbursements
- Maintained company required compliance guidelines
- Researched and respond to concerns by correspondence
Administrative Assistant
South Carolina Department of Health and Human Services
08.2017 - 07.2018
- Produced/distributed correspondence memos, letters, faxes and forms
- Answered and directed phone calls
- Wrote letters and emails on behalf of other office staff
- Covered the reception desk when required
- Maintained supplies inventory by determining anticipated needs, placing orders and verifying receipt
- Handled sensitive information in a confidential manner
- Took accurate minutes of meetings
Education
High School Diploma -
Timmonsville High School
Timmonsville, SC01.1991
Skills
- Customer Service/Conflict Resolution
- Windows
- Management
- Customer service
- Data entry
- Work under pressure
- Call Center
- HIPAA
- ICD-10
- Microsoft Office
- CPT Coding
- Insurance Verification
- Medical Terminology
- Purchasing
- ICD Coding
- Medical Records
- ICD-9
- Market Research and Analysis
- Team player
- Active listening
- Operations Analysis/Inventory Planning
- Finance Management/Payroll Administration
Personal Information
Authorized to work in the US for any employer.
Additional Information
Microsoft Office, Excel, Google teams, Zendesk, Outlook
Timeline
Provider Enrollment Analyst
Palmetto BCBS
04.2022 - Current
Eligibility Worker
South Carolina Department of Health and Human Services
11.2018 - 03.2021
Administrative Assistant
South Carolina Department of Health and Human Services
08.2017 - 07.2018
Claims Customer Service Advocate II
Blue Cross Blue Shield of South Carolina
02.2013 - 11.2018
High School Diploma -
Timmonsville High School