SUSAN BURNETT
Louisville,KY
Summary
Highly analytical Healthcare and Insurance professional combining more than 10 years of work in long term, specialty pharmacies with proficiency in; financial management, leadership administration and customer service.
Overview
18
18
years of professional experience
Work History
Provider Enrollment Coordinator
Baptist Health Medical Group
Louisville, KY
05.2019 - Current
- Establish relationships with Providers offices to ensure proper handling of documentation
- Routinely review and update provider files and rosters including, but not limited to individual/group CAQH profiles, payer databases, NPI/NPPES, PECOS, and any others
- Coordinate efforts with Managed Care to provide provider information and applications as required and to resolve contract issues related to provider enrollment
- Communicate with all necessary internal departments, as well as develop and maintain relationships with individual contacts for government agencies and managed care organizations
- Utilized effective active listening, interpersonal and communication skills in collaborating with different individuals on a daily basis
Medical Office Coordinator
Skyline Medical Group
Nashville, TN
09.2018 - 05.2019
- Managed various general office duties such as answering multiple telephone lines, completing insurance forms and mailing monthly invoice statements to patients
- Scheduled appointments for doctor visits and procedures using desktop calendar software
- Performed clerical tasks, including answering incoming phone calls, sorting mail and sending correspondence
Administrative Support Specialist
University of North Carolina Dental School
Chapel Hill, NC
07.2017 - 11.2017
- Demonstrated ability to multi-task, prioritize, and follow through while managing scheduling requests for 7 residents
- Played a critical role in facilitating all aspects of patient care, serving as a liaison between patient/family/provider
- Coordinated appointments, schedule meetings and handled travel arrangements for faculty and students
- Scheduled dental educational classes, committee meetings and daily requests
- Delivered exceptional customer service through direct communication with clients and team members
Patient Access Representative III
Express Scripts, Inc
Nashville, TN
08.2014 - 01.2017
- Established and maintained systems that safely met patients' needs with 100% compliance
- Tracked and monitored referral projects while communicating status regularly to providers, payers and others in the healthcare industry
- Maintained Department of health services compliance with zero deficiencies for over 3 years
- Clarified insurance benefits for specialty medications for patients and their families
- Achieved high staff morale and retention through effective communication, prompt problem resolution and proactive supervisory practices
- Performed medical/pharmacy benefit verification requiring complex decision skills based on payer and process knowledge resulting in on boarding or no starting a specialty patient
Financial Support Specialist/Reimbursement Specialist
Express Scripts
Nashville, TN
07.2007 - 08.2014
- Managed various general office duties such as answering multiple telephone lines, completing insurance forms and mailing monthly invoice statements to patients
- Billed AP/AR claims with 100% accuracy for 4 years
- Strategically planned methods to achieve operational goals, targets which succeeded in reducing bad debt by 13% within 9 months
- Supervised, coordinated activities of patient services representatives
- Collaborated with department managers to correct problems to improve services
- Reduced bad debt to below 1.5% within 10 months for Blue Cross Blue Shield payer exceeding the target goal of 1%
Education
Associate of Applied Science - Business Administration Iowa Falls
Ellsworth Community College
Iowa Falls, IA1983
Skills
- Medical and dental terminology
- Financial reporting and budgeting skills
- Cash handling expertise
- Ledger and balance sheet competency
- Deadline-driven
- Analytical thinking
- Prior authorization processing
- Account reconciliation
- Contract agreement preparation
- Re-credentialing processes
- Candidate sourcing
- Verifying insurance coverage
- Enrollment management
- License verifications
Timeline
Provider Enrollment Coordinator
Baptist Health Medical Group
05.2019 - Current
Medical Office Coordinator
Skyline Medical Group
09.2018 - 05.2019
Administrative Support Specialist
University of North Carolina Dental School
07.2017 - 11.2017
Patient Access Representative III
Express Scripts, Inc
08.2014 - 01.2017
Financial Support Specialist/Reimbursement Specialist
Express Scripts
07.2007 - 08.2014
Associate of Applied Science - Business Administration Iowa Falls
Ellsworth Community College
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