Data Entry Accounts Receivable

*************@******.***

SANCIA R. BROOKS, CBCS

PROFESSIONAL EXPERIENCE

STATELINE MOBILE NOTARY & FINGERPRINTING SERVICES Franklin, TN Notary Public, Fingerprinting Technician 7/2021- Current

• Dual Notary for the states of Tennessee and Kentucky

• Publicly commissioned official tasked with verifying the authenticity of documents and serve as impartial witnesses when signing legal documents. Authorized to witness the signing of legal documents, usually concerned with deeds, estates, licenses, power of attorney, affidavits, and trusts.

• Manual recording of legible fingerprints sequence accurately. WILLOW TREE HEALTHCARE GROUP Franklin, TN

A/R Specialist 9/2021-8/31/2022

• Daily review of Illinois & Kentucky orthopedic claims submitted electronically to proper insurance entities while identifying data processing issues to ensure claims process for payment

• Analyzing unpaid claims, resolution-oriented follow-up to achieve cash recovery and accounts receivable resolution goals of assigned physicians’ inventory following company policies and procedures

• Weekly team meeting to discuss inventory improvements, trends, and client expectations

• Daily phone calls to insurance companies to verify patient benefits, check claim status, and provide requested documentation to process claims for payments

• Assisting physicians’ office with claim corrections, aged accounts, and patient billing questions ENABLECOMP Franklin, TN

Revenue Specialist 4/2018- 9/2021

• Liaison between contracted clients and insurance companies for Georgia, Alabama, and Florida workers’ compensation facility claims, handling protected health information while maintaining extreme privacy and security as relates to confidential and proprietary information for Georgia state guidelines

• Verified and identified the correct claim carrier, claim number, status of the claim, date of injury, body part, billing address and claims adjuster to create the initial bill packet per company policy and procedure

• Uploaded all pertinent medical records, implant manufacturers invoices and any supporting documentation needed for initial bill submission, reconsiderations and appeals for claims reimbursement using fee schedules along with knowledge of PPO contracts

• Conducted timely and thorough telephone follow-up with payers to guarantee payment while maintaining above average quality, exceeding production quotas while collecting high to low dollar claims MAP COMMUNICATIONS Nashville, TN

Intake Specialist/ Point of Contact 5/2016- 7/2021

• Monitored call queues of incoming/outgoing calls and conducted special projects

• Assisted new intake specialists in training bay, side by side call monitoring for quality and training purposes or refresh training for veteran specialists to secured outbound and inbound calls regarding legal advice for potential clients to ensure accurate documentation for attorney review utilizing active listening skills while projecting empathy

• Troubleshooting client scripts, phone lines and technical issues with support before escalating to Management

PHYDATA Goodlettsville, TN

Radiology Coding Specialist 5/2017-2/2018

• Handled the daily DNFC (Discharged Not Finally Coded) report to ensure timely billing for clients

• Corrected all denials and monitored workflow throughout the department to proactively avoid denials

• Maintained the Radiology Charge Description Master (CDM) to ensure accurate charge capture

• Reviewed and maintained the data between the Radiology Information System (RIS)

• Performed front end coding to ensure proper charge capture for HIM coding to bill

• Performed document research on coding and regulatory healthcare issues including- websites, publications, insurance companies

PLANNED PARENTHOOD OF MIDDLE & EAST TN Nashville, TN Credentialing Specialist/ Billing Coordinator 3/2016- 11/2016

• Performed Full cycle billing duties daily to track revenue by identifying claim denial errors and trends by correcting edits on any rejected and denied claims reviewing explanation of benefits via the clearinghouse

• Insurance verification for billed services within 48 hours of scheduled appointments and walk-ins

• Billed government, commercial and private insurances while offering self-pay options

• Daily posting of clearinghouse payment files for accurate patient billing while reviewing overpayments, offsets, takebacks, refunds, and zero paid claims with account follow-up

• Physician Insurance Credentialing maintaining CAQH for practice physicians

• Physician Group and Individual contract enrollment (Aetna, Cigna, Blue Cross Blue Shield plans) SOLUTIONS MPM Nashville, TN

Account Analyst 7/2014- 2/2016

• Analyzed and corrected California urology claim inventory for accuracy to submit claims via EDI

• Daily follow up on all rejected, and denial claims to identify claim issues

• Analyzed and identified trends with their root causes within assigned inventory impacting charges, coding, collection, and accounts receivable utilizing the clearinghouse

• Audited current procedures to monitor and improve efficiency of billing and collections operations

• Weekly client meeting to discuss inventory and goals for unpaid claims, resolution-oriented follow-up to achieve cash recovery of assigned hospital receivables for monthly client invoicing MEDASSETS Nashville, TN

Patient Account Representative 9/2011- 4/2013

• Project Team Lead for multiple Long Term Care facilities in Arizona, Kansas, Louisiana, Mississippi, Texas, and Utah

• Prepared files for electronic bill submission to government, private, commercial insurance

• Responsible for follow-up on high dollar commercial claims from billing through final resolution using knowledge of payer contracts for maximum reimbursement

• Identified and corrected billing errors and claim denials with medical records, retro authorizations and documents needed for payment of claims by submitting appeals as necessary for account resolution

• Facilitated weekly meetings with management and clients to discuss the inventory

• Trained team on updates, process, and project changes to exceed monthly goals up to 2.5 million dollars. EDUCATION

NEW HORIZONS Nashville TN

Certified Billing and Coding Specialist, CBCS 2015 SKILLS

Management: Project Team lead (15-18) associates, New Rep/Peer training, Call Center Point of Contact, Leading Team Huddles- Goal review, Queue Monitoring, Hourly shift reports, Inbound and Outbound call escalation. Systems: EPIC, Cerner, NextGen, SSI, DDE, EDI, Citrix, Epremis, Summit, Star Applications, Meditech, Availity, Passport, Barracuda, ECHO and RDP.

Billing: UB-04, UB-92, CMS-1500 claims with extensive knowledge of CPT, REV codes ICD-9, ICD-10, & HCPCS Coding, Medical Terminology and CMS/Commercial Insurance policies, procedures, and guidelines. Account Receivables (Facility & Physician): Worker’s compensation, Women & Teen Health, Long Term Care, PT/OT, Acute Care, Urology, Dialysis, Radiology, Oncology, Veterans. Expert: High dollar claims collections, Inventory Analysis and Auditing of accounts for payment projections, denial review and aging.

Extensive Knowledge: Physician Radiology Coding, Credentialing, CAQH portal, and Provider enrollment. Clerical: Microsoft Word, Excel, Office, Outlook, PowerPoint, SQL reports; Key 65-70 wpm, 65-70 account production, inventory coordination and delegation.

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