Toni D. Brooks

**** ********* *****

Lexington NC. 27292

Cell: 240-***-****

Home: 336-***-****

Email: ac176h@r.postjobfree.com

Summary:

An accomplished professional with over 30 years of experience working in the Healthcare industry. Knowledge of health insurance, reimbursement, appeals process and financial expectations pertaining to healthcare. Thorough understanding of insurance practices and policies. Adapt at interacting with clients and addressing customer service issues. Strong communication and interpersonal skills. A self starter who is comfortable working independently or as a team member.

Skills:

Knowledge of the following system programs: HomeCare HomeBased, McKesson, Health Quest, Power Chart, MVP Live, Medicaid Web / EVS. Centricity,IDX, IEXCHANGE, MS Office, Workday. Knowledge of medical terminology and basic office operating equipment.

Holy Cross Home Care and Hospice Silver Spring, Maryland

Billing Coordinator 2014 to 2017

Billing Coordinator Skills and Qualifications:

Reporting research results, analyzing information, data entry, maintaining patient confidentiality.

Excellent writing and communication skills, attention to detail.

Accurately coded and processed invoices from multiple vendors for prompt payment.

Performed audits on major vendor accounts for billing accuracy.

Ran weekly report to identify patients who had applied for Maryland Medical Assistance. Updated system once eligibility had been established.

Updated patients account to reflect demographic or insurance changes. Transferred charges to reflect changes in account status.

Responsible for generating and distributing weekly reports to Medical Records and Document Specialist for followup.

Reviewed Bill Register report on a weekly basis and corrected any errors that may prevent claims from being paid.

Resolved billing issues in a timely manner for patients and vendors by phone and/or mail correspondence.

In charge of completing end of month spread sheet and reporting all numbers to the Corporate Office Finance Manager.

Maintained vendor files for follow up accuracy if necessary.

Attended monthly conference call to review outstanding revenue.

Trained my replacement as Billing Coordinator and performed other duties as assigned.

Other accomplishments

Originally hired as an Office Coordinator and promoted to Billing Coordinator after two months.

Appointed to be the voice of Motivation and Inspiration by my Supervisor and the Director.

TheraCom Rockville, Maryland

Reimbursement Case Advocate I 2009 to 2011

(Growth Hormone Therapy)

•Handled new case referrals from various Healthcare providers as well as re-certification for current patients.

•Verified all aspects of medical and pharmacy benefits including on-line verification of pharmacy benefits.

• Ensured that patient had sufficient medication until verification and authorization process was complete by working closely with specialty pharmacies.

•Obtained required medical documents from Physicians office to ensure proper submission of authorization request.

•Verbally provided clinical information to the insurer to review for prior authorization.

•Effectively interfaced with Health Care Providers office staff to pursue patient reimbursement cases.

•Provided patient and provider office staff with weekly updates to the status of the case.

TheraCom Rockville, Maryland

Reimbursement Case Advocate I 2007 to 2009

(Pain Management Therapy)

Accurately processed any incoming orders which included data entry to create new cases and updating existing cases.

Accountable for verifying all aspects of medical and pharmacy benefits to ensure that all information was correctly reported to the physician’s office.

Responsible for providing clinical information to the insurer to obtain prior authorization.

Promptly answered all incoming calls to assist caller with the requested information.

Reported directly to supervisor weekly and monthly reconciliation reports which provided management with reliable statically data.

Responsible for Quality Control of disposition notes and reported discrepancies to Team Lead.

Assisted Team Lead with signature audits and updating monthly reconciliation report.

Trained new employees in various aspects of TheraCom processes.

Adventist Healthcare, Potomac Ridge Behavioral Health Rockville, Maryland

Senior Patient Account Representative 1992 to 2007

Assisted Director of Admissions in the building process of new registration program.

Reviewed employee time sheets for accuracy.

Assisted in benefit verification process to ensure maximum reimbursement from payers.

Responsible for oversight of registration process for admissions and discharges.

Key patient data into system so proper documents can be generated.

Reviewed records for accuracy and compliance with regulations.

Discussed patients’ financial responsibility and payment options.

Resolved customer grievances and resolve escalated complaints.

Maintained reports pertaining to activities including month end reconciliation, reserve log, outpatient billing and upfront cash collections.

Other positions held within the company

Assistant Business Office Manager

Patient Account Representative/Patient Service Representative

Accomplishments:

Received numerous “Recognition of Outstanding Customer Service” and “Recognition of Appreciation” awards. Consistently met company monthly collection goals. Leadership Training Certification.

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