SUSAN BROWN
Universal Health Systems
N. Las Vegas,NV
21
years of professional experience
2
Languages
Strong background in coordinating business operations with internal and external stakeholders. Effective at streamlining processes, resolving issues, and improving communication. Results-driven Revenue Cycle professional with various years of experience. Skilled with in-depth knowledge of state and federal insurance guidelines and processes. Proactive in identifying issues with utmost confidence in practical solutions.
Work History
CUSTOMER SERVICE REP II
15 Years 5 Months- Assessed eligibility for homeless write-offs through comprehensive account reviews.
- Analyzed charity applications to verify patient qualifications for in-house programs.
- Ensured proper balance adjustments by updating accounts meticulously. Streamlined the review process of accounts and charity applications.
- Managed the claims process by updating accounts with status details from start to finish, ensured effective communication of the claim status from initial submission to completion.
- rectified discrepancies and errors in customers accounts.
- Managed confidential records sensitively while ensuring data integrity. Generated timely reports that align with stringent managed care policies and external payment guidelines. Adhered to federal, state, and county regulations for insurance documentation.
PROVIDER SERVICE REPRESENTATIVE II
3 Years 8 Months- Assisted medical providers and facilities with CMS-Medicare audit reviews to ensure compliance and accuracy.
- Facilitate consistent tracking and documentation of authorizations to achieve maximum reimbursement for services and increase team awareness.
- Maintained consistent follow-up on status of prior authorization requests.
- Compiled daily reports detailing activities and outcomes.
- Facilitated tracking and documentation of authorizations to maximize reimbursement for services and enhance team awareness.
- Builds and sustains cooperative working relationships across organization, interacts with collaborations to resolve issues and deliver results.
- Maintained follow-up on prior authorization requests to ensure timely processing and resolution.
- Collected relevant records for specific issues, ensured completeness and accuracy, and attached records to correspondence.
SR. CLINICAL ADMIN COORDINATOR
4 Years 3 Months- Oversee and instruct front office personnel in daily operations, resolve customer issues and inquiries, handle daily financial transactions, and facilitate new employee orientations.
- Facilitated financial objectives through evaluation and enhancement of purchasing, payroll, and empanelment operations.
- Facilitated achievement of financial objectives by evaluating and enhancing purchasing, payroll, and empanelment operations.
- Oversaw front office personnel in daily operations, resolved customer issues and inquiries, handled daily financial transactions, and facilitated new employee orientations.
- Delegated tasks to administrative support staff to organize and improve office efficiency.
- Managed staff development and performance evaluations to ensure alignment with organizational goals.
- Provided backup to front desk by assisting with tasks during employee absences.
- Delegated tasks to administrative support staff to organize office operations and improve efficiency.
FINANCIAL COUNSELOR
2 Years- Engaged patients and family members to confirm insurance details and assess financial capabilities for healthcare services, ensuring informed decision-making
- Analyze diverse assistance programs (federal, state, county) to fulfill patient financial requirements.
- Facilitated completion of paperwork for patients and family members, streamlining the process to obtain financial assistance
- Function as intermediary among patients, family members, insurance providers, and assistance program personnel to finalize assignments, payment documentation, COBRA benefit appeals, etc.
- Monitored charity care program applications to track progress and compliance.
- Advised patients on drug replacement and reimbursement programs, enhancing access to necessary medications.
- Outlined healthcare resources and programs available for patients unable to fulfill financial commitments.
- Coordinated with insurance providers to gather crucial information on patient benefits and provide required documentation for accounts.
Education
Associates - Healthcare Administration
Skills
Claims resolution management
Management of claim submissions
Dispute resolution expertise
Payment processing assistance
Client support
Account relationship development
Office administration
Proficient in Microsoft Office
Strategic assessment
Critical thinking
LANGUAGES
English
Full Professional
Timeline
PROVIDER SERVICE REPRESENTATIVE II
HealthData Insights
01.2013 - 09.2016Read More
CUSTOMER SERVICE REP II
Universal Health Systems
04.2011 - CurrentRead More
SR. CLINICAL ADMIN COORDINATOR
United Health Care
01.2008 - 04.2012Read More
FINANCIAL COUNSELOR
Nevada Cancer Institute
01.2006 - 01.2008Read More
University of Phoenix
Associates from Healthcare Administration
Read More