Brenda L. Phipps

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

St. Louis Mo 63136

(Home) 314-***-**** (Cell) 314-***-****

(Email) ac1epx@r.postjobfree.com

Summary:

Transferable Skills and Excellent Customer Service.

Corporate professional with years of experience in the Patient Access Department. Proven success in meeting department or the organization needs and deadlines.

Magellan Healthcare (2016-2017) Seasonal

Eligibility Processor II

Data entry, and customer service.

Responsible for enrolling Medicare Part A & B customers into the Medicare Part D prescription drug plan. Consistently working in the Medicare Close contact with Medicare, knowledge of traditional Medicare Part A & B and customer contact when necessary. Job responsibilities: Responsible for enrolling Medicare Part A & B customers into the Medicare Part D Prescription Plan. Contact customers if needed to complete an application. Maintain professionalism at all time.

SSM Healthcare (2005-2015)

Claims Resolution /Payment

One of four lead people to resolve claims with payment or billing issue. Ability to resolve atleast 95% of claims received from supervisors or other team members. Review and correction of claim made within a timely manner by using acquired knowledge of insurance carriers contract per the providers contract with the carrier. Ability to aid others team members, supervisor or other department (when needed) in the interpretation of the claim payment.

Claims Auditor/Collections Representative/Customer Service/Trainer

Responsible for working medical insurance claims from start to finish. (Medicare; Medicaid; Tricare/ChampaVA and all commercial claims) Close working relationship with the medical coders, when the claims were not paid per the provider/carrier contract due to billing issues. Recognize ICD-9 and Revenue codes associated with HCFA1500 (CMS 1500) and the UB92/UB04 medical claims.

Brenda L. Phipps

(Home) 314-***-**** (Cell) 314-***-****

(Email) ac1epx@r.postjobfree.com

SSM Healthcare (1997-2005)

Worked with the insurance billers when necessary to rebill claims, when requested from the insurance carriers. Trained new employees on their specific job duties. Responsible for resolving issues on “escalated” insurance claims and patient calls in a timely manner.

Accomplishments:

Successfully completed a work assignment to collect 1.5 million dollars from the outstanding A/R within a two year period (2012-2014)

Completed (2) Master Degree programs while working a full time job.

Opportunity to work with 2 new small business owners in the St. Louis Mo area assisting them in specific areas of human resources and marketing.

Lead clerk of the Tabernacle of Praise Seventh Day Adventist Church, working closely with the Pastor, Elders and the Financial Department.

Education:

Lindenwood University St. Charles Mo.

M.B.A. Communication 2015

M.S. Human Resource Management 2012

REFERENCES:

Vicki Bill

SSM Healthcare

Manager Financial Clearance/Pre Registration Department.

314-***-**** ac1epx@r.postjobfree.com