CLARISSA THOMPSON BROOKS

336-***-****

ad1ssj@r.postjobfree.com http://www.linkedin.com/in/clarissabrooks0118

Qualifications An achiever with twenty plus years of experience as a phenomenally successful Healthcare Medical Billing Specialist, Customer Service Representative, and Clerical Professional. Have always set high standards and consistently achieved set goals. Highly motivated and strive to be on top of any position represented.

Employment Robert Half, (Client Tipper Tie), Apex, NC September 2023 - Present

Accounts Receivable Collections Clerk

•Obtaining a hands-on experience that will provide exposure to the different functions in an accounting department.

•Contributing to the goals that support our Accounting initiatives.

•Prepares, posts, verifies, and records customer payments and transactions related to accounts receivable.

•Maintains and updates customer files, including name or address changes, mergers, or mailing attentions.

•Drafts correspondence for standard past-due accounts and collections, identifies delinquent accounts by reviewing files, and contacts delinquent accountholders to request payment.

•Creates reports regarding the status of customer accounts as requested.

•Collaborates with the AR lead to reconcile accounts receivable on a monthly basis.

•Assists in generating monthly billing statements based on the general ledger.

•Copies, files, and retrieves materials for accounts receivable as needed.

•Relays changes of information to appropriate employees.

Spectraforce Technologies (Client AbbVie), Durham, NC November 2022 – July 2023

Insurance Specialist II

•Provide subject matter expertise and best-in-class customer service for all inbound and outbound customer calls to drive first call resolution. Provide insurance coverage, verification details prior authorization statues and alternate funding options for existing and newly launched products. Provide offices with current plan forms, portals, and websites for prior authorizations and appeal submissions. Clearly communicate and educate customers on the results of the investigation.

•Investigate and problem solve for patients experiencing escalated issues such as disadvantaged or complex access, savings card/copay card challenges or non-preferred formulary issues. Where necessary, complete a benefit investigation, contact the HCP and/or patient or potentially the filling pharmacy or payor.

•Quickly learn and execute business process and system changes for all drugs and channel sources as applicable. Maintain an understanding of current business procedures, deviations, and case processing for all brands and channel sources for Insurance Specialist I role to support as needed.

•Documents information in the appropriate system of record and formats. Accurately communicate insurance details to HCP and patients via phone, other electronic communication methods and fax, as per established policies and procedures.

•Identify potential Adverse Event situations for reporting to Pharmacovigilance ensuring AbbVie meets FDA regulations.

Duke University Health Systems (PRMO), Durham, NC April 2021 – September 2022

Patient Account Associate Authorization Denials

•Insured confidentiality of patient information through HIPAA Compliance. (Remote)

•Maintained knowledge base on changes to reimbursement, including but not limited to

specific managed care contracts, Medicare/Medicaid guidelines, and third-party insurance payers.

•Initiated appropriately timed correspondence and telephone contact to clarify and explain account situations with patients or guarantors, employers, insurance companies, and sponsoring agencies; obtains cooperation toward settlement of account.

•Maintained accountability for the prompt reprocessing of authorization denied claims.

•Obtained and followed up on all documentation needed to bill.

•Verified the ICD 9/10 and CPT coding for all hospital billing denied authorization claims to be billed to patient’s insurance.

•Experienced in medical records including knowledge of inpatient and outpatient records with multiple specialty settings.

•Investigated denials from insurance companies to insure claim resolution.

•Prioritized accounts to maximize dollars in collections.

•Utilized with high proficiency all computer applications of Microsoft Office 365 such as Microsoft Word, Excel, Access, PowerPoint, and Outlook.

•Notified supervisor of problem accounts and/or clinical issues that need to be addressed related to billing, collections, and coding issues.

•Clearly notated databases as specified by supervisor.

•Submitted appropriate documentation for adjustments and write-offs.

•Traveled to the office once or twice a week to complete mailing needs.

•Demonstrated ability to prioritize work and meet deadlines.

•Demonstrated skills to plan and work independently with minimal supervision.

•Demonstrated skills to work effectively with all levels of staff, supervisors and public.

Duke Homecare and Hospice, Durham, NC November 2019 – April 2021

Patient Account Associate Infusion Billing/Collections

•Insured confidentiality of patient information through HIPAA Compliance.

•Maintained knowledge base on changes to reimbursement, including but not limited to

specific managed care contracts, Medicare/Medicaid guidelines, and third-party insurance payers.

•Initiated appropriately timed correspondence and telephone contact to clarify and explain account or coverage situation with patients or guarantors, employers, insurance companies, and sponsoring agencies; obtains cooperation toward settlement of account.

•Maintained accountability for the prompt processing of claims including billing, claims transmission, and the collection of those claims, for a set group of accounts assigned.

•Obtained and followed up on all documentation needed to bill.

•Experienced in medical records including knowledge of inpatient and outpatient records with multiple specialty settings.

•Notified supervisor and data manager regarding any medical documentation requested by payer sources, or patients.

•Managed the ICD 9/10 and CPT coding for all claims to be billed to patient’s insurance.

•Investigated denials from insurance companies to insure claim resolution.

•Prioritized accounts to maximize dollars in collections.

•Notified supervisor of problem accounts and/or clinical issues that need to be addressed related to billing and collections.

•Researched and resolved delinquent accounts to ensure timely collections and reduce DSO.

•Utilized with high proficiency all computer applications of Microsoft Office 365 such as Microsoft Word, Excel, Access, PowerPoint, and Outlook.

•Clearly notated databases as specified by supervisor.

•Submitted appropriate documentation for adjustments, write-offs, refunds, or bad debt to the appropriate Supervisor, Accounts Receivable.

•Demonstrated ability to prioritize work and meet deadlines.

•Demonstrated skills to plan and work independently with minimal supervision.

•Demonstrated skills to work effectively with all levels of staff, supervisors and public.

The Heag Pain Management Center, Greensboro, NC November 2018 -November 2019 Revenue Cycle Administrator

•Liaison between the practice and the main billing company.

•Submitted medical claims to billing company for payment.

•Contacted Insurance regarding claim status, Denials, Outstanding Payments, and Authorizations.

•Managed the ICD 9/10 and CPT coding for all claims to be billed to patient’s insurance.

•Utilized with high proficiency all computer applications of Microsoft Office 365 such as Microsoft Word, Excel, Access, PowerPoint, and Outlook.

•Communicated with patients regarding their visit payments.

•Managed all Prior Authorizations for future procedures and Pharmacy requests.

•Experienced in medical records including knowledge of inpatient and outpatient records in pain management and some behavioral health settings.

•Sent Medical Records per request to insurances and submits appeals for denied claims.

•Always Maintained a professional manner and positive work environment.

•Accurately monitored and resolved negative issues with the revenue to have a positive outcome.

•Demonstrated ability to prioritize work and meet deadlines.

•Demonstrated skills to plan and work independently with minimal supervision.

•Demonstrated skills to work effectively with all levels of staff, supervisors and public.

Berkley Medical Management Solutions, Greensboro, NC February 2017- August 2018

Medical Bill Review Customer Service Professional Workers’ Compensation

•Managed Inbound and Outbound calls from internal and external customers.

•Directed callers to appropriate departments or staff when necessary.

•Analyzed and compiled data for a quick and proper response.

•Completed Contact Log, Voicemails and Provider Outreach Calls daily.

•Met departmental goals for productivity, monitor scores, and accuracy.

•Documented relevant written and oral communication appropriately.

•Always Maintained a professional manner and positive work environment.

•Recognized and informed Supervisor regarding trends in internal and external customer calls.

Spectraforce Technologies, (Client BCBSNC), Winston Salem, NC August 2016 - February 2017

Customer Service Professional

•Functioned as a service relationship management professional for company’s customers,

employer groups and providers to successfully service healthcare insurance needs.

•Provided consistent, reliable, and customized stakeholder service interactions in a highly

efficient and effective manner.

•Strengthened the company’s brand by developing, managing, and expanding customer

relationships at service levels that meet and exceed customer expectations.

•Processed orders, prepared correspondence, and fulfilled customer needs to ensure

customer satisfaction.

•Knowledge of commonly used concepts, practices, and procedures within a

particular field.

Education Allen School of Health Science, Jamaica, NY Graduated 2015 Certificate in Medical Billing and Coding

Southern Alamance High School, Graham, NC Graduated 1989

Basic High School Studies and Computerized Accounting

Contact this candidate