Marcie Britten
Middleville,MI
Summary
Detail-oriented Auditor with knowledge in varied insurances. Performed audits and identified numerous issues that led to client cost savings. Excellent data analysis and organizational skills enabled impressive results. Training and development experience to help identify future training needs with the department. Quick and eager learner with acute attention to detail and consistent track record of identifying process improvements to drive quality, accuracy and efficiency.
Overview
25
25
years of professional experience
Work History
Quality and Training Specialist
Tokio Marine HCC - Stop Loss Group
Kennesaw, GA
04.2023 - Current
- Developed and maintained training materials, including job aids, handouts, and presentations.
- Implemented performance management systems to track employee progress against established goals.
- Provided technical support during online training events using web conferencing tools.
- Provided ongoing coaching and mentoring services to help learners improve their skillsets.
- Managed multiple projects simultaneously while adhering to tight deadlines.
- Facilitated classroom instruction for groups up to 6 students
- Created assessments to evaluate the effectiveness of training programs.
- Awarded certificates to employees who completed training to recognize accomplishments, boosting motivation and retention.
- Evaluated and communicated trainee participation and performance in reports to management.
- Tracked attendees, participation and understanding of course material.
- Mentored and onboarded new staff members to establish top client satisfaction.
- Managed training calendars to inform participants of upcoming training session topics and dates.
Stoploss Specific Auditor
Tokio Marine HCC- Stop Loss Group
Kennesaw, GA
07.2022 - 04.2023
- Processed Stoploss reimbursement claims for multiple insurance TPA's
- Respond to client requests in timely manner
- Examined claims, records and procedures to grant approval of reimbursement.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Resolved routine and complex issues by performing detailed research.
- Maintained reserve thresholds on Monthly and quarterly basis to ensure money allocated for future claims.
- managed tasks and pends ensuring we received all information with filing limits.
Claims Training and Development Coordinator
ASR Health Benefits
Grand Rapids, MI
02.2021 - 04.2022
- Organized handbook and course documentation for participants.
- Prepared custom training course materials and presentations for training.
- Planned and led training programs on staff development to enhance employee knowledge, engagement, satisfaction and performance.
- Presented training information via role playing, simulations and team exercises.
- Led trainings for up to 15 employees on weekly basis.
- Successfully trained 8 individuals of differing knowledge and background.
- Trained 13 Members in an international bases via zoom.
- Liaison for international department for queries,
- assisted in auditing of all trainees
- Handled reports to track production and accuracy for all trainees
- powerpoint refresher for claims department on new policies
- updated documentation for procedural changes
- assisted in development of Current staff to ensure accuracy
- ensured training staff prioritized work to complete all tasks
- point person for staff for assistance in claims processing
- researched trilogy to better assist analysts to ensure correct claims processing.
Medical Claims Analyst
ASR Health Benefits
Grand Rapids, MI
09.2004 - 02.2021
- Reviewed administrative guidelines whenever questions arose during the processing of claims
- Efficiently and effectively processed a large volume of medical claims on a daily basis
- Stayed current on HIPAA regulations, benefits claims processing, medical terminology, and other procedures
- Based the payment or denials of medical claims upon well-established criteria for claims processing
- Ensured claims were billed and paid correctly
- Provided respectful assistance to all parties, including patients, staff members and insurance company representatives
- Obtained all necessary information to complete proper evaluation of injury claims
- Delivered exceptional customer service to all clients by effectively communicating information and actively listening to concerns
- Reviewed policies to determine appropriate levels of coverage and assist with approval or denial decisions
- Developed exceptional attendance record with special attention to punctuality and preparation to work upon arrival
Hospital Patient Registration Rep
Metro Health Hosp
Grand Rapids, MI
07.2005 - 03.2015
- Collected and processed copayments and out-of-pocket charges using Epic
- Worked with nurses and other clinical staff to process patients and direct to appropriate departments
- Interviewed patients to collect medical information and insurance details
- Processed patient payments and scanned identification and insurance cards
- Communicated with all partners throughout the practice including physicians, nursing staff, technicians and medical assistants
- Entered patient information including insurance, demographic and health history into the system to ensure that all records were up-to-date
- Observed strict HIPAA guidelines at all times according to company policy
Medical Biller/self Pay Team Lead
Pine Rest Christian Mental Health Services
Grand Rapids, MI
01.2000 - 09.2004
- Effectively coordinated all communications between patients, billing personnel and insurance carriers
- Submitted claims to insurance companies
- Organized information for accounts more than 200 days past due and transferred to a collection agency
- Collected, posted and managed patient account payments
- Performed with precision by entering data accurately and researching to resolve questions
- Reviewed account information to confirm patient and insurance information is accurate and complete
- Identified new techniques to improve workflows and addressed each with the department manager and CFO
- Reviewed all claims for accurateness and appropriateness
- Answered desk phone and handled phone calls and questions
- Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts
- Reviewed received payments and applied to the appropriate patient accounts
- Completed and submitted appeals
- Applied HIPAA Privacy and Security Regulations while handling patient information
- Filed and submitted insurance claims
- Researched and rectified account discrepancies
- Maintained composure and level-headed mentality during challenging situations to best resolve situations and serve business needs
- Promoted to leadership position in recognition of strong work ethic and demonstrated ability to provide exceptional customer service
- Monitored employee performance and safety, conducting retraining to correct problems and optimize productivity
- Trained new employees on collection process and billing positions to support team efficiency
- Communicated and coordinated with multiple departments to achieve top results
Education
Bachelor of Arts - Recreation Facilities Management
Central Michigan University
Mount Pleasant, MI12.1993
Skills
- Production monitoring
- Decision making
- Excellent problem solving skills
- Claims processing
- Goal-oriented
- Superior communication skills
- Cheerful and energetic
- Dependable and reliable
- Claim validity determination
- Medical terminology
- Reporting abilities
- Regulatory compliance understanding
- Conflict resolution
- Documentation skills
- Customer service
- People skills
- Organization
- Microsoft Office
Timeline
Quality and Training Specialist
Tokio Marine HCC - Stop Loss Group
04.2023 - Current
Stoploss Specific Auditor
Tokio Marine HCC- Stop Loss Group
07.2022 - 04.2023
Claims Training and Development Coordinator
ASR Health Benefits
02.2021 - 04.2022
Hospital Patient Registration Rep
Metro Health Hosp
07.2005 - 03.2015
Medical Claims Analyst
ASR Health Benefits
09.2004 - 02.2021
Medical Biller/self Pay Team Lead
Pine Rest Christian Mental Health Services
01.2000 - 09.2004
Bachelor of Arts - Recreation Facilities Management
Central Michigan University
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