Elonna Brown
Whitsett,NC
Summary
Administrative Coordinator/Care Coordinator/Patient Services
Specialist/Insurance Agent
Dedicated, detail-oriented administrative professional with history of success in organization, coordination and operations management. Highly skilled in processing claims, resolving issues, and managing insurance and patient coding and billing. Extensive experience in relationship management and patient services in dynamic, high-pressure environments. Vast expertise in regulating state and federal billing practices, and leadership. Backed by insights into accounting, payroll systems, and automated office procedures. Demonstrated excellence in communicating with colleagues, liaising with stakeholders, and forging strong professional relationships. Proven track record in solving problems issues, providing support, and ensuring documents, data, and reports are accurate and appropriately filed. Flexible and adept at multi-tasking, time management, and critical thinking as well as proficient in strategic planning and verbal, written, and interpersonal communication.
Overview
22
22
years of professional experience
1
1
Certification
Work History
Warehouse Associate
Amazon
12.2023 - Current
- Pick customer orders from shelves or storage locations using handheld devices.
- Prepare and pack orders for shipment by picking, packing, and labeling merchandise to ensure safe and secure deliveries.
- Use technology, such as scanners and conveyor belts, to assist in order processing.
- Perform inventory counts and reconcile discrepancies as needed.
- Worked safely around moving machinery.
- Collaborated with team members to achieve daily targets and complete tasks efficiently.
Customer Service Representative II
Elevance Health
11.2022 - 11.2023
- Initiate 30 or more authorizations for inpatient stays, deliveries and observations.
- Received inbound calls from providers to discuss program eligibility.
- Educated members and providers about features and benefits.
- Honor standards for quality and efficiency.
Customer Service Representative
Elevance Health
11.2021 - 11.2022
- Receive 50 or more inbound calls from members to discuss program eligibility.
- Educate members about features and benefits.
- Update member coordinating of benefits.
- Honor standards for quality and efficiency.
- Resolve customer complaints with empathy, resulting in increased loyalty and repeat business.
- Part of communications committee and tasked to send the team bi-weekly timesheet reminders via Outlook and MS Teams
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
Revenue Cycle Representative/Medicare/Tricare/Hospice
UNC Healthcare
02.2019 - 11.2021
- Ensure accurate and timely claims payment for claims
- Conducting 50 or more post payment review on claim denials, including follow-up with payers to appeal denials or underpayments
- Performs complex duties in support of reimbursement from patients and insurance carriers for assigned clinical department
- Review of manual claims, determining documentation and information necessary to meet third party requirements, obtaining the information and filing the claim for processing
- Updating patient and payer claim information based on edits or rejections, reviewing the history of a claim in Epic, reversing denials from carriers, recoding denied claims, troubleshooting issues, and identifying coding trends.
- Improved revenue cycle efficiency by streamlining processes and implementing best practices.
- Negotiated payment arrangements with patients experiencing financial difficulties, reducing write-offs and maintaining positive relationships with clients.
- Identified root causes of claim denials through thorough analysis, implementing corrective actions for improved results moving forward.
- Coordinated closely with clinical staff to ensure proper documentation was submitted for accurate billing purposes.
Claims Coding Specialist/Physician Billing-Integrated Bill Team
UNC Healthcare
05.2016 - 02.2019
- Handled Agency payer denials and claim follow-up
- Helped train staff on new denial processes
- Worked charge review work queues which included auditing and reviewing Hospice claims that required modifiers in order to be billed and paid by Medicare
- Worked coding denials and identified the specific denial reasons for coders to review for coding compliance and submitted for charge corrections
- Experience in screening certain Agency payers for non-covered HCPCS/CPT and ICD10 codes based on fee schedule
- Input charge correction requests for consultation codes that required the appropriate E&M code based on Crosswalk coding guidelines.
- Reduced error rates in medical billing by maintaining thorough knowledge of insurance regulations and guidelines.
- Maintained strict confidentiality in accordance with HIPAA regulations, ensuring secure storage and handling of sensitive patient information.
Patient Financial Services Rep/Physician Billing-Integrated Bill Team
UNC Healthcare
05.2015 - 05.2016
- Utilized Availity system to edit claims
- Worked Sovera system issues
- Completed WC Correspondence Insurance Forms
- Worked 40 or more PB WQ 238 Psychotherapy Resident Clinic work queues with $25 Copay
- Worked PB WQ 330 Statement Intervention Inmate work queues
- Received Emails from Linda Tingen system to help resolve claim issues
- OOS Medicaid
- Fax and Mail University Hospital Claims
- Directed BCCP forms to claim reps
- Returned mail from DOC
- Worked Student Athlete WQs PB WQ 16248 and HB WQ 109 work queues
- Submitted PB and HB Claims after Insurance is added
- WC Claim Edits and Charge Review Work Queues.
McGovern Davison Children's Health Center/Financial Care Counselor
Duke University Hospital
01.2012 - 05.2015
- Obtain 40 or more Prior Authorization Certification and or authorizations
- Calculate and collect cash payments appropriately for all patients
- Complete the managed care waiver form for patients considered out of network and receiving services at a reduced benefit level
- Update the billing system to reflect the insurance plan contracts and guidelines
- Communicate with insurance carriers
- Resolve issues relating to coverage and payment
- Proficient in using EPIC System.
Duke Eye Center/Patient Service Associate
Duke University Hospital
08.2008 - 01.2012
- Prepare 50 or more clinic visits by reviewing next day patients and completing next day activities
- Enter pre-visit orders and prepare new patient charts
- Pick up office charts/medical records and petty cash/collection bags
- File history sheets and other patient record documentation
- Schedule test and procedures
- Prepare/investigate encounter forms for accuracy
- Schedule appointments through IDX, answer phones, take and deliver messages as required by policy and procedure
- Schedule bloodwork, MRI's, CT Scans, and X-rays through DHIS with proper diagnosis codes
- Assist physician's assistant with special projects.
- Supported clinical staff by organizing and maintaining patient records for easy access and updated documentation.
Rapid Resolution Expert
United Health Group
01.2005 - 08.2008
- Reviewed and researched complexed claims by accurately locating data to process claims
- Updated 40 or more claim information based on research and communication from member or provider
- Completed adjustments to claims and ensured the proper benefits were applied to each claim by using the appropriate processes and procedures
- Completed daily data entry
- Communicated with members and providers regarding adjustments to resolve claim errors/issues.
- Reduced escalation rates by proactively identifying potential issues and providing appropriate solutions.
Customer Care Professional
United Health Group
01.2003 - 05.2005
- Received 60 or more inbound calls from members to discuss discount program eligibility
- Educate members about features and benefits
- Process customer claims
- Update member coordination of benefits
- Honor production standards for quality and efficiency.
- Collaborated with team members to improve overall performance, sharing best practices and pooling resources for optimal results.
Education
Bachelor of Science -
Southern New Hampshire University
Hooksett, NH05.2027
Certificate - Accounting Software Specialist Certificate
Brookstone College of Business/Accounting Software Specialist
Greensboro, NC06.1997
HIGH SCHOOL DIPLOMA -
Eastern Randolph High School
Ramseur, NC06.1987
Skills
- Compliance Quality Assurance
- Packaging and Labeling
- Lifting and sorting
- Labeling and boxing
- Order Picking
- Order picking and processing
- Heavy Lifting
- Pallet jacking
- Problem-Solving
- Order Fulfillment
- Sorting and Labeling
- Stacking and Staging
Areas of Expertise
- Administration & Coordination
- Claims Management
- Regulatory Compliance
- Quality Assurance
References
Available Upon Request
Certification
- Knowledgeable and experienced with HCSPC/CPT and ICD9/ICD10 coding and HMO, PPO, POS, and Medicare plans, OneNote, Palmetto GBA.
- Proficient in using Epic System, Microsoft Word, Excel & Lotus, Ten-Key Calculator, Automated Office Procedures, Accounting and Payroll Procedures, Database & Spreadsheet.
- Accounting Software Specialist Certificate Brookstone College of Business
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Warehouse Associate
Amazon
12.2023 - Current
Customer Service Representative II
Elevance Health
11.2022 - 11.2023
Customer Service Representative
Elevance Health
11.2021 - 11.2022
Revenue Cycle Representative/Medicare/Tricare/Hospice
UNC Healthcare
02.2019 - 11.2021
Claims Coding Specialist/Physician Billing-Integrated Bill Team
UNC Healthcare
05.2016 - 02.2019
Patient Financial Services Rep/Physician Billing-Integrated Bill Team
UNC Healthcare
05.2015 - 05.2016
McGovern Davison Children's Health Center/Financial Care Counselor
Duke University Hospital
01.2012 - 05.2015
Duke Eye Center/Patient Service Associate
Duke University Hospital
08.2008 - 01.2012
Rapid Resolution Expert
United Health Group
01.2005 - 08.2008
Customer Care Professional
United Health Group
01.2003 - 05.2005
Bachelor of Science -
Southern New Hampshire University
Certificate - Accounting Software Specialist Certificate
Brookstone College of Business/Accounting Software Specialist
HIGH SCHOOL DIPLOMA -
Eastern Randolph High School
- Knowledgeable and experienced with HCSPC/CPT and ICD9/ICD10 coding and HMO, PPO, POS, and Medicare plans, OneNote, Palmetto GBA.
- Proficient in using Epic System, Microsoft Word, Excel & Lotus, Ten-Key Calculator, Automated Office Procedures, Accounting and Payroll Procedures, Database & Spreadsheet.
- Accounting Software Specialist Certificate Brookstone College of Business
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