Brandy Hawthorne
Spartanburg,SC
Summary
Cordial Patient Access Specialist with demonstrated customer service skills in all interactions, with both external and internal customers. Social and communicative with high regard for sensitive and confidential information. Clear understanding of HIPAA rules and insurance protocols.
Overview
22
22
years of professional experience
Work History
Denial Specialist
Spartanburg Regional
01.2021 - Current
- Maintained knowledge of insurance coverage guidelines, eligibility, and verification processes.
- Improved claim denial resolution by thoroughly researching medical records, obtaining authorization, and identifying root causes of denials.
- Reduced aging accounts receivable balance by submitting timely appeal submissions for denied claims.
- Collaborated with billing department to ensure accurate coding and charge entry, minimizing future claim denials.
- Increased overall productivity by implementing efficient denial tracking and follow-up processes.
Patient Access Specialist
Prisma Health
08.2018 - Current
- Explains insurance benefits and estimated cost for medical treatments. Answers patient questions to promote good understanding of proposed services.
- Monitors department work-ques for errors, completing all errors to ensure proper billing.
- Gathers forms and copies insurance cards to collect patient information for billing and insurance filing.
- Obtained Pre-Authorizations for Infusion series appointments for the Infusion center, confirming times with patients and preparing admission and consent forms.
Physician Practice Specialist/Pre-Registration
Greenville ENT, Prisma Health
07.2011 - 08.2018
- Enhanced patient outcomes by providing knowledgeable education on procedures, medications and other physician instructions.
- Exceeded office goals for collection of surgery deposits and procedures.
- Supported duties for diagnostic and technical treatment procedures, such as setting up PET CT Scans for Head and Neck Cancer patients.
- Initiated prior authorizations for hi-tech imaging with insurance carriers prior to testing dates.
- Input all patient data regarding claims and prior authorizations into system accurately.
Physician Practice Specialist
Center for Adult and Family Medicine
12.2007 - 07.2011
- Scheduled and obtained pre-certification for high-tech imaging and diagnostic procedures.
- Obtained prior authorization for medication denials.
- Entered and updated patient demographics and medical history with accuracy.
- Maintained 4 provider schedules with accuracy.
- Collected patient co-payments, exceeding practice collection goals.
Shift Coordinator
Emeritus at Bellaire Place
05.2005 - 12.2007
- Ensured that all facility, assessment, and medical forms were completed with accurately.
- Interpreted management directives, performed daily assignments and completed special projects.
- Addressed guest concerns and resolved all issues to guests’ satisfaction.
- Scheduled and coordinated family meetings and resident assements.
Team Lead
Greenville Place Assisted Living
05.2002 - 05.2005
- Coordinated employee schedules to ensure that each unit was properly staffed.
- Reviewed and assigned task flow assignments to staff members.
- Completed new resident confidentiality forms. Updated family contact information.
- Obtained medical history and diagnosis to ensure resident files were complete.
Education
Medical Billing And Coding
Greenville Technical College
Greenville, SC08.2024
BBA - Business Administration
Southern Wesleyan University
Central, SC2019
Associate of Arts - Business Administration
Southern Wesleyan University
Central, SC2017
Associate of Applied Science - Medical Assistant
ECPI University
Greenville, SC 2008
Skills
- Proficient with EPIC computer systems
- Medical Authorizations
- Strong communication skills
- Medical Billing
- Effective time management
- Dependable/Proactive nature
- ICD-10 & CPT Proficient
- Medical Terminology
Timeline
Denial Specialist
Spartanburg Regional
01.2021 - Current
Patient Access Specialist
Prisma Health
08.2018 - Current
Physician Practice Specialist/Pre-Registration
Greenville ENT, Prisma Health
07.2011 - 08.2018
Physician Practice Specialist
Center for Adult and Family Medicine
12.2007 - 07.2011
Shift Coordinator
Emeritus at Bellaire Place
05.2005 - 12.2007
Team Lead
Greenville Place Assisted Living
05.2002 - 05.2005
Medical Billing And Coding
Greenville Technical College
BBA - Business Administration
Southern Wesleyan University
Associate of Arts - Business Administration
Southern Wesleyan University
Associate of Applied Science - Medical Assistant
ECPI University
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