Ebone Faulkner
BALTIMORE,MD
Summary
Dynamic Provider Enrollment Specialist with a proven track record at GBMC HealthCare, excelling in credentialing data coordination and relationship building. Successfully implemented provider acquisition initiatives, enhancing service margins. Adept at navigating complex insurance processes, demonstrating strong performance monitoring and data entry proficiency to optimize patient care and operational efficiency.
Overview
9
9
years of professional experience
Work History
Provider Enrollment Specialist
GBMC HealthCare - Greater Baltimore Medical Center
08.2025 - Current
- Created and implemented provider acquisition initiative with focus on high-margin services.
- Prepared and processed provider enrollments with Medicare and Medicaid in multiple states.
- Contacted insurance carriers to obtain information regarding denials.
- Monitored credentials and contacted practitioners when expiration dates were nearing.
Family Caregiver
Self Employed
11.2024 - 07.2025
- Engaged patients in meaningful conversation, socialization, and activity while providing personal care assistance.
- Assisted clients with daily living needs to maintain self-esteem and general wellness.
- Changed dressings, bandages, and binders to maintain proper healing and sanitary measures.
- Assisted with feeding and monitored intake to help patients achieve nutritional objectives.
Claims Reviewer
State of Maryland Workers Compensation Commission
05.2023 - 10.2024
- Verified and investigated employment claims and data.
- Monitored and updated claims status in claims processing system.
- Managed high-volume caseloads, ensuring timely claim reviews, follow-up, and resolution.
- Identified and reported claim discrepancies, preventing financial loss and ensuring compliance.
- Maintained accurate claim records in electronic systems to support audits and reporting.
Accounts Receivable and Billing Specialist
Johns Hopkins Hospital
02.2017 - 05.2023
- Reconciled accounts receivable ledger to verify payments and resolve variances.
- Prepared and mailed invoices to customers, processed payments, and documented account updates.
- Submitted cash and check deposits and generated cash receipts to record money received.
- Reviewed accounts on monthly basis to assess aging and pursue collection of funds.
- Negotiated payment arrangements with customers to establish timely receipt of payments.
Prior Authorization Specialist
Cigna Health System
03.2017 - 01.2023
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Researched denied claims and contacted insurance companies to resolve these issues.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
Education
High School Diploma - Health Administration
Northern Senior High School
Baltimore, MDSkills
- Medicaid refunds & credits
- Hospital claims processing & clean claim submission
- Payment posting & reconciliation
- Denials & appeals resolution
- Accounts receivable follow-up
- Microsoft Office Suite (Word, Excel, Outlook, PowerPoint)
- Epic & Meditech systems
- Patient & payer communication
- Cash flow optimization
- HIPAA compliance
Timeline
Provider Enrollment Specialist
GBMC HealthCare - Greater Baltimore Medical Center
08.2025 - Current
Family Caregiver
Self Employed
11.2024 - 07.2025
Claims Reviewer
State of Maryland Workers Compensation Commission
05.2023 - 10.2024
Prior Authorization Specialist
Cigna Health System
03.2017 - 01.2023
Accounts Receivable and Billing Specialist
Johns Hopkins Hospital
02.2017 - 05.2023
High School Diploma - Health Administration
Northern Senior High School
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