Shanta Franklin
Augusta,GA
Overview
9
9
years of professional experience
Work History
Provider Enrollment Specialist
WellStar MCG Health
Augusta, GA
08.2021 - Current
- Kept watchful eye on physician expiration dates and contacted practitioners to inform when such dates were near.
- Collaborated with internal departments to ensure proper processing of enrollment applications.
- Prepared weekly summaries detailing newly enrolled providers, pending applications, rejected applications.
- Provided guidance to providers on the enrollment process, timelines, and requirements.
- Conducted audits of existing providers' records to verify continued eligibility for participation in network programs.
- Created detailed reports outlining updates made to provider profiles as well as any issues or errors encountered during processing activities.
- Followed up with insurance carriers to address and rectify denied claims.
- Responded promptly to inquiries from providers regarding their status within the network.
Patient Financial Counselor
AU Medical Center
Augusta, GA
02.2019 - 08.2021
- Maintained knowledge of current health care regulations related to billing practices.
- Researched discrepancies between charges and payments received from insurance companies or other sources.
- Collaborated with hospital staff members to resolve complex billing issues.
- Provided clear explanations of billing policies and procedures to both internal and external customers.
- Created monthly reports summarizing collections activity and billing trends.
- Performed follow up calls to collect outstanding balances from patients who were unable to make payments at time of service.
- Processed credit card payments accurately and securely.
- Developed rapport with patients to discuss sensitive financial matters in a professional manner.
- Assisted patients in understanding the details of their bills, including deductibles and co-pays.
- Monitored changes in federal, state, and local regulations affecting Medicare and Medicaid reimbursements.
- Verified patients' insurance and payment methods during admissions or check-in processes.
- Collaborated with clinical and administrative staff to meet patient needs.
- Obtained informed consent and payment documentation from patients and filed in system.
Unit Clerk
University Hospital - University Health System
Augusta, GA
03.2015 - 12.2017
- Provided assistance to nurses and other healthcare professionals in the delivery of patient care.
- Monitored vital signs including pulse rate, temperature, respiration rate and blood pressure.
- Assisted with ambulation and positioning of patients according to their plan of care.
- Answered call lights promptly to ensure timely response to patient needs.
Timeline
Provider Enrollment Specialist
WellStar MCG Health
08.2021 - Current
Patient Financial Counselor
AU Medical Center
02.2019 - 08.2021
Unit Clerk
University Hospital - University Health System
03.2015 - 12.2017
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