SHANTEL BRIGHTMON
WYLIE,US
Summary
Kidney Transplant Coordinator with over 12 years of extensive expertise in insurance verification and medical billing, adept at navigating complex patient billing issues and ensuring compliance with regulatory standards. Demonstrates strong analytical thinking and critical problem-solving skills, effectively liaising between medical teams and insurance providers to streamline patient care processes. Passionate about enhancing healthcare documentation and patient satisfaction through innovative solutions and efficient workflow management.
Overview
12
12
years of professional experience
Work History
Kidney Transplant Coordinator
Medical City Dallas Hospital
03.2023 - Current
- Liaison for transplant patient billing issues
- Maintain communication between the Revenue Cycle Operations team, professional services, Contracting/Managed Care, and Transplant department on specific patient accounting and billing issues
- Contact insurance companies to find pertinent information regarding policies and payment benefits
- Input patient and insurance information into Trans chart system
- Effectively communicated answers regarding billing, treatment and scheduling by phone and in person
- Maintain compliance with local, state and federal regulations governing insurance, Medicare, and Medicaid requirements.
- Setup and enter Single Case Agreements SCAs/LOAs in Ctrax system.
- Train coworkers on Kidney on obtaining authorizations, including terminology, diagnosis, and cpt codes
- Monitor patient journey from referral through post-transplant care while ensuring strict compliance with Medicare, Medicaid, and insurance regulations.
Pre-Authorization Coordinator
Baylor Scott & White Hospital
07.2013 - 10.2022
- Managed complex insurance pre-authorizations, streamlined documentation processes, and coordinated with healthcare providers to ensure timely patient care approvals
- Processed high-volume authorization requests while maintaining accuracy standards, reducing processing time and enhancing patient satisfaction
- Built strong relationships with insurance providers and medical teams, facilitating smooth communication channels for expedited authorization outcomes
- Implemented efficient tracking systems for authorization status, leading to improved workflow management and reduced pending cases
- Advocated for patient needs while ensuring compliance with insurance requirements, resulting in enhanced care access and reduced claim denials
- Streamlined pre-authorization protocols through strategic process improvements, resulting in accelerated approval timelines and reduced patient wait times
Education
Bachelor's - Psychology
Purdue Global University
10.2025
Diploma - undefined
North Dallas High
Skills
- Insurance Verification (Experienced)
- Prior Authorization
- Medical Billing (Skillful)
- Microsoft Excel (Experienced)
- Analytical Thinking (Experienced)
- Critical Thinking (Experienced)
- Customer Service (Experienced)
- Healthcare Documentation (Experienced)
- Medical Coding
- Patient Advocacy
- Time Management
- Team Collaboration
- Regulatory Compliance
Timeline
Kidney Transplant Coordinator
Medical City Dallas Hospital
03.2023 - Current
Pre-Authorization Coordinator
Baylor Scott & White Hospital
07.2013 - 10.2022
Bachelor's - Psychology
Purdue Global University
Diploma - undefined
North Dallas High
COURSES
- BASIC OF MEDICAL BILLING & CODING 2024 Alison Empower
- MEDICAL BILLING AND CODING: ICD 10 AND 11 2024 Alison Empower
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