Ethel M. Brockington
Riverview
Summary
Detail-oriented and motivated professional with comprehensive experience in real estate law, title insurance, and legal administration. Equipped with a Real Estate Paralegal certificate and a strong background in managing property transactions, legal document preparation, title searches, and administrative support. Seeking to leverage skills in a legal support role to contribute effectively to a real estate or law firm environment.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Medicare Specialist
TTEC
Tampa
02.2022 - 06.2024
- Assisted in reviewing and preparing legal documents related to Medicare claims, disputes, and appeals, ensuring compliance with state and federal regulations
- Conducted research on legal issues related to Medicare fraud, billing issues, and compliance investigations
- Provided internal teams with guidance on regulatory compliance, helping to prevent legal challenges and streamline operational procedures
- Drafted contracts for Medicare-related services, ensuring alignment with healthcare laws
Accounts Receivable/Medicare Specialist
HPONE
Tampa
07.2021 - 01.2022
- Processed Medicare claims and reviewed all invoices for accuracy, ensuring that documentation met legal and compliance standards
- Conducted legal research related to unpaid or underpaid claims and resolved issues involving Medicare Administrative Contractors (MACs)
- Maintained records for legal audits and regulatory reviews, ensuring compliance with Medicare guidelines and federal regulations
- Acted as a liaison between healthcare providers and regulatory agencies, ensuring timely and accurate resolution of claims
Managed Care Collections/Account Representative
AdventHealth (Florida Hospital)
Tampa
09.2019 - 06.2021
- Managed a portfolio of insurance claims, ensuring timely processing and resolution of disputes
- Reviewed medical records and billing documents for accuracy, identifying legal discrepancies that could impact reimbursement
- Ensured proper escalation of uncollected accounts in accordance with legal requirements and corporate standards
- Worked closely with patients, providers, and legal teams to resolve billing disputes and interpret insurance coverage
Pharmacy Authorization Tech/Claims/Medicare/Medicaid Specialist
Prime Therapeutics
Eagan
03.2018 - 08.2019
- Managed prior authorization processes for Medicare and Medicaid claims, ensuring compliance with healthcare regulations
- Provided legal documentation and support for insurance claims, focusing on compliance with government programs
- Conducted outreach to providers, physicians, and pharmacies to gather necessary legal information for claims resolution
- Supported audits and maintained records to ensure compliance with formulary change transitions and legal documentation standards
Medicare Member Services Representative (Medicare Advantage Plans)
BroadPath Healthcare Solutions
Tucson
04.2017 - 02.2018
- Interpreted complex healthcare and legal documents related to insurance claims, medical records, and regulations
- Assisted members and providers in resolving claims disputes, ensuring compliance with federal and state insurance laws
- Reviewed medical and legal documentation for completeness and accuracy to ensure successful claims processing
Licensed Health Enrollment/Claims Representative
Health Plan Services
Tampa
10.2014 - 04.2017
- Managed insurance claims processing, reviewing legal documents, policies, and medical records to ensure proper billing and compliance
- Worked closely with legal teams to ensure accurate claim adjudication and resolution of disputes
- Provided customer service for legal inquiries, including plan eligibility, claims, and benefits
Customer Service Professional
Convergys Call Center
Columbia
03.2014 - 10.2014
- Processed insurance claims, ensuring compliance with legal and contractual guidelines
- Communicated effectively with customers and vendors to resolve billing disputes, following company procedures and legal requirements
- Documented claims processing activities and provided legal support on insurance claims management
Medical Claims Processor
Ivans
Tampa
02.2009 - 03.2014
- Processed medical claims, ensuring compliance with legal and regulatory standards
- Analyzed and adjudicated claims, identifying legal issues related to reimbursement and coding
- Worked with legal teams to resolve disputes and ensure accurate claims processing
Education
Real Estate Paralegal Certificate -
Hillsborough Community College
Tampa, FL12.2024
Diploma -
Middleton High School
Tampa, FL01.1984
Skills
- Property transactions
- Contract review
- Title searches
- Legal document preparation
- Compliance with real estate regulations
- Legal research
- Case management
- Document preparation
- Office management
- Client correspondence
- Medicare/Medicaid regulations
- Insurance claims compliance
- Healthcare laws
- Microsoft Office Suite
- Legal Research Tools (Westlaw)
- Case Management Software
- Cerner
- SalesForce
- CMM (Cover My Meds)
- Exceptional communication
- Client relations
- Negotiation
- Dispute resolution skills
- Proficient in medical coding (ICD-10)
- Legal terminology
- Claims processing
- Billing
Certification
- 240 Health Insurance License, Tampa, FL, 01/01/15, Present
- Florida Notary, Remote Online Notary (RON), Certified Notary Signing Agent
Timeline
Medicare Specialist
TTEC
02.2022 - 06.2024
Accounts Receivable/Medicare Specialist
HPONE
07.2021 - 01.2022
Managed Care Collections/Account Representative
AdventHealth (Florida Hospital)
09.2019 - 06.2021
Pharmacy Authorization Tech/Claims/Medicare/Medicaid Specialist
Prime Therapeutics
03.2018 - 08.2019
Medicare Member Services Representative (Medicare Advantage Plans)
BroadPath Healthcare Solutions
04.2017 - 02.2018
Licensed Health Enrollment/Claims Representative
Health Plan Services
10.2014 - 04.2017
Customer Service Professional
Convergys Call Center
03.2014 - 10.2014
Medical Claims Processor
Ivans
02.2009 - 03.2014
Real Estate Paralegal Certificate -
Hillsborough Community College
Diploma -
Middleton High School
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