Erica Brisbon
Creditial Specialist
Decatur,AL
Summary
Experienced credentialing professional with a strong background in managing and verifying credentials for healthcare providers. Adept at fostering team collaboration and delivering consistent results. Known for reliability and adaptability, consistently meeting organizational standards and compliance requirements. Exceptional skills in data management, regulatory compliance, and effective communication.
Overview
17
17
years of professional experience
Work History
Product Support Agent
Concentrix
12.2024 - Current
- Delivered high-quality remote assistance to clients experiencing technical difficulties, guiding them through step-by-step solutions
- Enhanced customer satisfaction by promptly resolving product-related issues and providing effective solutions.
- Maintained up-to-date product knowledge through regular training sessions, ensuring accurate information was provided to customers.
- Boosted team productivity by sharing product knowledge and troubleshooting techniques with fellow support agents.
- Championed company-wide initiatives focused on enhancing overall customer experience, resulting in increased satisfaction scores and positive brand perception.
Customer Service Agent
Williams-Sonoma, Inc.
10.2023 - 09.2024
- Effectively managed escalations from dissatisfied customers, working closely with management to ensure timely resolutions that maintained brand reputation.
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Utilized strong problem-solving skills to quickly identify and address customer issues.
- Maintained a high level of professionalism when interacting with customers, ensuring positive experiences.
- Demonstrated empathy in handling difficult situations, fostering trust and loyalty among customers.
Credentialing Specialist
Abington Hospital - Jefferson Health
07.2017 - 05.2021
- Collaborated with healthcare providers to gather necessary information for accurate credentialing decisions.
- Managed multiple priorities effectively, resulting in the on-time completion of credentialing tasks for numerous providers simultaneously.
- Conducted audits of provider files, ensuring all necessary documents were up-to-date and compliant with regulatory requirements.
- Enrolled providers and Medicaid, Medicare, and private insurance plans.
- Conducted primary source verifications such as background checks and board certifications.
- Safeguarded confidential provider information by adhering to strict data privacy regulations and company policies.
- Received and evaluated applications to look for missing and inaccurate information.
- Obtained NPI numbers for providers and facilities and updated existing profiles.
- Demonstrated excellent problem-solving skills when confronted with complex issues or discrepancies during the credentialing process.
- Developed strong relationships with external organizations, leading to increased cooperation during verification processes.
- Provided exceptional customer service to both internal and external stakeholders, addressing inquiries promptly and professionally.
Medical Claims Processor
Holy Redeemer Hospital
06.2011 - 07.2017
- Coordinated with insurance companies to clarify billing issues.
- Followed up on pending claims to ensure timely processing.
- Updated claims system with relevant information and notes.
- Processed claims by verifying patient information and insurance coverage.
- Communicated with healthcare providers to resolve discrepancies in claims.
- Processed high volumes of medical claims accurately and efficiently under tight deadlines, ensuring prompt payment for services rendered.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Verified patient insurance coverage and benefits for medical claims.
- Monitored and updated claims status in claims processing system.
- Evaluated medical claims for accuracy and completeness and researched missing data.
Patient Service Representative
Kramer & Associates OB GYN
03.2008 - 06.2011
- Assisted patients with registration processes, verifying personal information and insurance details.
- Handled patient inquiries regarding services and billing, providing clear and accurate information.
- Applied billing and coding software to process insurance claims, reducing errors and expediting payment.
- Participated in ongoing training programs related to HIPAA compliance, maintaining up-to-date knowledge on regulatory requirements.
- Verified insurance eligibility and coverage for patients.
- Handled sensitive patient concerns with professionalism and empathy, fostering an atmosphere of trust within the clinic.
- Provided exceptional customer service to patients, answering questions and addressing concerns.
- Handled customer service inquiries in person, via telephone and through email.
- Assisted patients in filling out check-in and payment paperwork.
- Processed medical records requests efficiently, safeguarding patient privacy while ensuring timely information access for healthcare providers.
Education
Bachelor of Science - Healthcare Administration
University of Phoenix
Washington, DC05.2008
Skills
- EMR Systems
- Empathy and patience
- Escalation management
- Cerner
- Epic
- HIPAA compliance
- Background checks
- Provider enrollment
- Data management
- Medical terminology expertise
- Claims management
- Insurance verification
Timeline
Product Support Agent
Concentrix
12.2024 - Current
Customer Service Agent
Williams-Sonoma, Inc.
10.2023 - 09.2024
Credentialing Specialist
Abington Hospital - Jefferson Health
07.2017 - 05.2021
Medical Claims Processor
Holy Redeemer Hospital
06.2011 - 07.2017
Patient Service Representative
Kramer & Associates OB GYN
03.2008 - 06.2011
Bachelor of Science - Healthcare Administration
University of Phoenix
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