Remote Data Entry & Medicaid Specialist

CHRISTINA BRITTON

INSURANCE • MEDICAID • REVENUE CYCLE • PATIENT ADVOCACY

Lanoka Harbor, NJ 08734 732-***-**** **********@*******.***

PROFESSIONAL PROFILE

Experienced healthcare insurance and revenue cycle professional with 15+ years of progressive experience across skilled nursing, orthopaedics, and patient financial services. Expertise in Medicare, Medicaid, commercial insurance, long-term care Medicaid eligibility, payer verification, authorizations, accounts receivable, claims and denial resolution, and patient financial counseling. Known for analyzing complex coverage issues, coordinating with payers and government agencies, supporting timely reimbursement, and delivering high-quality service to patients, residents, families, and internal teams.

CORE COMPETENCIES

Medicare & Medicaid

Commercial Insurance

Long-Term Care Medicaid

Revenue Cycle Management

Insurance Verification

Eligibility & Benefits

Prior Authorizations

Claims & Denial Resolution

Accounts Receivable

Payer Coordination

Patient Financial Counseling

Payment Collections

Systems & Additional Expertise: PointClickCare (PCC), eClinicalWorks, EMR systems, medical terminology, staff training and mentoring, interdepartmental collaboration.

PROFESSIONAL EXPERIENCE

QUALITY HEALTHCARE RESOURCES Tracker / Medicaid Specialist

September 2018 – Present

• Manage insurance verification and payer eligibility for new skilled nursing facility admissions, ensuring accurate coverage and payer assignment.

• Monitor resident insurance coverage throughout the stay to support uninterrupted reimbursement and accurate billing.

• Track long-term care Medicaid applications from submission through approval, coordinating with county assistance offices, residents, responsible parties, and facility staff.

• Lead weekly Accounts Receivable meetings with client facilities to review outstanding accounts, payer issues, aged balances, and Medicaid application status.

• Research complex Medicaid eligibility and coordination issues and recommend solutions to Business Office Managers.

• Collaborate with billing teams to resolve collection challenges, aged accounts, payer discrepancies, and patient liability balances.

• Maintain monthly HMO and payer tracking reports and complete census updates to keep payer information accurate within tracking systems.

• Serve as a liaison among skilled nursing facilities, county agencies, billing departments, residents, and responsible parties throughout the Medicaid approval process.

SEAVIEW ORTHOPAEDIC – OCEAN, NJ Lead Patient Advocate

2010 – 2018

• Obtained insurance authorizations for diagnostic testing, fracture care, injections, durable medical equipment (DME), and specialty procedures.

• Processed out-of-network authorizations and gap exception requests to secure patient coverage and access to care.

• Verified Medicare, Medicaid, commercial insurance, and out-of-network benefits prior to treatment.

• Educated patients regarding benefits, deductibles, copayments, financial responsibility, and payment options.

• Ensured complete and accurate insurance documentation to support timely billing and reimbursement.

• Coordinated Medicaid benefits and payer-of-last-resort requirements while resolving insurance and patient billing inquiries.

• Collected patient payments and established payment arrangements for outstanding balances.

• Reviewed referrals and authorizations for accuracy before services were rendered.

• Trained and mentored new team members on insurance processes, eligibility verification, and departmental procedures.

• Led a team of five Patient Advocates while maintaining high standards of customer service and operational efficiency.

SEAVIEW ORTHOPAEDIC – OCEAN, NJ Scheduler / Workers’ Compensation & No-Fault Coordinator

2006 – 2010

• Scheduled appointments for Workers’ Compensation, No-Fault, and commercial insurance patients.

• Coordinated care and communication among physicians, nurse case managers, employers, and insurance carriers.

• Served as the primary liaison between physicians and Workers’ Compensation case managers.

• Reviewed Independent Medical Examination (IME) reports and coordinated physician responses and appeals.

• Maintained accurate scheduling and insurance documentation while ensuring timely communication among all parties.

CAREER VALUE

Combines hands-on payer knowledge, Medicaid eligibility expertise, revenue cycle support, patient advocacy, authorization management, and team leadership. Particularly well suited for roles in healthcare insurance, Medicaid eligibility, revenue cycle management, patient financial services, skilled nursing billing, payer operations, and healthcare administrative support.

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