Open To Work
Fran Clarke
Conway,USA
Work Preference
Summary
Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Overview
24
24
years of professional experience
Work History
Administrative Coordinator II
Waccamaw Center for Mental Health
Conway, SC
01.2023 - Current
- Oversaw billing team, managed revenue cycles, and ensured accurate and timely reimbursement from insurance providers.
- Supervise and manage a team of billing specialists, providing guidance, training, and support to ensure optimal performance.
- Oversee the entire billing process, including claim submission, payment posting, and reconciliation.
- Submit claims to commercial insurance companies, Medicare, Medicaid, managed care plans, and other payers.
- Analyzed billing data to identify trends and enhance revenue through targeted improvements.
- Ensure compliance with all relevant healthcare billing regulations, including HIPAA and state-specific requirements.
- Address patient billing inquiries, complaints, and complex issues in a professional and timely manner.
- Prepared and analyzed financial reports, focusing on revenue cycle metrics and compliance to support strategic decision-making.
- Participate in special projects and initiatives related to billing and revenue cycle management.
- Utilized strong knowledge of insurance billing regulations and coding systems (e.g., ICD-10, CPT).
- Managed and motivated a team of billing specialists to enhance performance and productivity.
- Utilized analytical and problem-solving skills to assess billing discrepancies and implement solutions.
- Exercised proficiency in Microsoft Office Suite and billing software to streamline reporting and data management.
Biller
Lighthouse Behavioral Health Hospital
Conway, SC
10.2010 - 01.2023
- Ensured financial health of organization through diligent management of billing processes.
- Accurately submit claims, resolve claim payment issues, support the Billing Manager, train new staff, and address patient billing inquiries.
- Leveraged experience with various insurance carriers, including private insurance, Medicare, Medicaid, and managed care to streamline claims processing.
- Streamlined processes for revenue collection and management.
- Utilize problem-solving skills, leadership potential, patient-focused approach, and financial acumen.
Administrative Coordinator I
Waccamaw Center for Mental Health
Conway, SC
09.2016 - 12.2020
- Supervised billing team for four outpatient mental health clinics, ensuring accurate and timely processing of claims.
- Submit claims to commercial insurance companies, Medicare, Medicaid, managed care plans, for payment for treatment.
- Coordinated billing team efforts to complete compliance audits and special projects, supporting center administrators' objectives.
- Investigated and resolved claims payment issues by collaborating with insurance companies and analyzing claim data.
- Resolved patient billing issues by reviewing account details and collaborating with insurance providers for effective communication.
- Respond to patient questions, complaints, and complex inquiries.
- Post payments to client accounts, while making sure funds balance and reconcile monthly.
- Trained all department staff to meet department goals and standards.
Direct Care Staff
Seacoast Youth Academy
Myrtle Beach, SC
07.2017 - 11.2019
- Provide a safe, supportive, and nurturing environment for young people.
- Work closely with youth to help them develop essential life skills, build positive relationships, and achieve their goals.
- Establish positive relationships with youth, providing guidance, support, and mentorship.
- Monitored and supervised youth activities to ensure safety and well-being.
- Assisted in planning and implementing programs and activities, including academic support, recreational activities, and counseling sessions to enhance youth development.
- Respond to crises and emergencies in a calm and effective manner.
- Maintain accurate and timely documentation of youth interactions and program activities.
- Collaborate with other staff members to ensure a positive and supportive environment for youth.
- Engaged in community outreach initiatives to strengthen connections with local youth.
Financial Counselor
Lighthouse Behavioral Health Hospital
Conway, SC
07.2009 - 10.2010
- In an inpatient mental health facility, ensure the financial well-being of the organization and its patients.
- Provided personalized financial counseling, collected payments, and assisted patients in understanding insurance benefits and billing processes, enhancing patient financial literacy.
- Educate patients and their families about insurance benefits, copays, deductibles, and out-of-pocket costs.
- Developed and managed payment plans for patients requiring extended payment terms, improving patient satisfaction and financial compliance.
- Collect payments from patients, including cash, checks, credit cards, and insurance reimbursements.
- Addressed complex billing inquiries from patients, insurance companies, and other stakeholders, facilitating clear communication and resolution of financial issues.
- Maintain accurate patient financial records in the electronic health record (EHR).
- Prepare accurate and timely accounting and collection reports for the CFO and Business Office Director.
- Ensure compliance with all relevant financial regulations and policies.
Mental Health Technician
Lighthouse Behavioral Health Hospital
Conway, SC
06.2002 - 07.2009
- Assisted in the direct care and management of patients across all age ranges with medical and behavioral issues.
- Demonstrated understanding of safe, supportive, nurturing, and therapeutic interactions to foster patient well-being.
- Implemented behavior program strategies and established appropriate boundaries to support patient compliance and safety.
- Assisted with unit programming to enhance therapy carryover, leisure activities, and daily living skills tailored to patients' functional abilities and developmental levels.
- Engaged in positive interactions with patients, peers, and families to foster a supportive environment.
- Supervise therapeutic and recreational activities.
- Exercise leadership by training new employees.
- Utilize problem-solving techniques and utilize effective verbal and written communication skills.
Claims Associate III
Blue Cross Blue Shield of South Carolina, PGBA, LLC
Surfside Beach, SC
10.2006 - 01.2009
- Examine and process claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines.
- Review claims or appeals issues, complaints, and inquiries referred by claims customer service representatives to determine if desk procedures and guidelines were followed.
- Research and respond to complex customer inquiries, ensuring that contract standards and objectives for timeliness, productivity and quality are met.
- Researched underlying causes of claims issues to develop preventive and corrective measures.
- Identified and reported potential fraud and abuse situations to ensure compliance with regulations.
- Handle situations that require adaptation of response or extensive research.
- Provided management with feedback on customer issues to inform service improvements.
- Maintained accurate records concerning customer issues for effective tracking and resolution.
- Followed through on complaints to ensure resolution or escalate to management.
- Assist with process improvements by recommending improvements in procedures and policies.
- Assists in training claims customer service representatives.
Education
Master of Business Administration - Business Administration and Management
Lander University
Greenwood, SC08.2025
Bachelor of Applied Science - Business Administration and Management
Lander University
Greenwood, SC08.2024
Skills
- Project management and support
- Data analysis
- Microsoft Office proficiency
- Research and analysis
- Data collection and processing
- Compliance adherence
- Business strategies
- Management and leadership
- Leadership in change management
- Decision making
- Strategic thinking
- Problem solving
- Collaboration and teamwork
- Communication skills
- Customer service and support
- Conflict resolution
- Critical thinking
- Presentation skills
- Public speaking
- Employee development
- Report writing
Financial revenue
Continuous improvement
KPI development
Insurance products
Staff training
Improvement recommendations
Controls system maintenance
Human resources
Proficient in Tableau and Excel
Financial audits
Internal controls
Financial analysis
Cost accounting
Credit analysis
Financial management
Organizational development
Performance appraisal
Team building
Career development
Human resources operations
Employee relations
References
- Dionne Savage, Lead RBHS Specialist, Horry County Schools, (843)492-1419, dsavage@horrycountyschools.net
- Lavonda Knox, LMSW, Horry County Schools, (843)455-0558
- Suzanne Wright, Administrative Assistant, Horry County Schools, (843)957-3884
- Suzanne Moose, Accountant Lead, (704)438-2722, suzannemoose@gmail.com
- Gabrielle Gale, Chief Financial Officer, Armour Oaks, (816)704-1689, ghonchell@armouroaks.org
- Felicia Graham, Appeals Supervisor, (843)246-9952, Msfelicia98@gmail.com
Languages
Spanish
Limited
Software
Tableu, Excel, Power Point, SAP
Timeline
Administrative Coordinator II
Waccamaw Center for Mental Health
01.2023 - Current
Direct Care Staff
Seacoast Youth Academy
07.2017 - 11.2019
Administrative Coordinator I
Waccamaw Center for Mental Health
09.2016 - 12.2020
Biller
Lighthouse Behavioral Health Hospital
10.2010 - 01.2023
Financial Counselor
Lighthouse Behavioral Health Hospital
07.2009 - 10.2010
Claims Associate III
Blue Cross Blue Shield of South Carolina, PGBA, LLC
10.2006 - 01.2009
Mental Health Technician
Lighthouse Behavioral Health Hospital
06.2002 - 07.2009
Master of Business Administration - Business Administration and Management
Lander University
Bachelor of Applied Science - Business Administration and Management
Lander University