Senoia Brantley

Summary

A background of experience in the healthcare industry; its products and services, medical terminology, insurance complexities, as well as familiarity with clinical components the electronic health record, contracts configuration, medical billing/collections revenue cycles, personnel supervision, HIPAA compliance, and data base administration

Work History

Work History

Configuration Analyst

Freedom Health Plans
  • Oversee Business Configuration projects.
  • Conducts gap analysis discovery between business requirements and system functionality.
  • Possesses a high degree of expertise in the configuration of business rules that support reimbursement policies and methodologies in a large managed care organization.
  • Performs complex data modeling and database design with minimal oversight.
Mar 2008 - May 2009

Configuration Specialist

WellCare

•Loaded professional & institutional contracts into the Diamond System through appropriate research and provider data load activities •Performed accurate and timely provider research, verification and analysis•Loaded new providers as a result of the approved Credentialing Committee Lists•Assisted in updating payable procedure codes, price rules and fee schedules•Reviewed Hospital Contracts to ensure they can be administered•Communicated with Provider Relations when contracts can not be administered properly.•Applied a comprehensive knowledge of provider data management to the completion of assignments.

Jun 2003 - Mar 2008

National Billing Analyst

Gentiva Health Services

•Worked closely with the Contracts Department staff, regional Sales Representatives, and Data Management to develop and implement appropriate billing formats.•Worked closely with the Billing Analyst team to coordinate activities ensuring accurate billing across the Gentiva Health Services® and CareCentrix® network of over 350 nursing branches nationwide.•Worked proactively with the Sales organization to ensure that appropriate and deliverable billing formats are presented to prospective payers.•Reviewed payer specific billing, pricing, coding, and coverage rules during contract negotiations to ensure contracts can be effectively serviced by the system. •Ensured all information received was accurate and complete to mitigate risk of lost revenue as a result of the rate load and billing process•Coordinated with I/S Department to evaluate special billing format requests.•Provided Account ID setup/maintenance information to Data Management to ensure accurate and correctly formatted invoices. •Validated and submitted payer specific rate table changes to Data Management.

Jun 2002 - Jun 2003

Senior Collector

Apria Healthcare
  • Analyzed and tracked billing errors between payers and Apria Healthcare within the contractual agreements.
  • Maintained cash collection at %96 of average 90 day trailing revenue cycle according to Apria's best practices.
  • Maintained revenue adjustments at or below %6 of total revenue.

Education

Education

St. Petersburg college

Bachelors Candidate

St. Petersburg College
PROGRAM REQUIREMENTSCGS 1060 - BASIC COMPUTER AND INFORMATION LITERACY1    or (Computer/Information Literacy Competency Requirement)HSC 1531 - MEDICAL TERMINOLOGY2a BSC 1083 - HUMAN ANATOMY (Lab is not required) OR (BSC 2085/L and BSC 2086/L)3HSC 1149C - GENERAL PHARMACOLOGY FOR HEALTH PROFESSIONALS1HIM 1430 - PRINCIPLES OF DISEASE3HIM 2222 - BASIC ICD CODING3HIM 2253 - BASIC CPT CODING3HIM 1000 - INTRODUCTION TO HEALTH INFORMATION MANAGEMENT3HSA 1100 - HEALTHCARE DELIVERY SYSTEMS3HIM 1211 - HEALTH INFORMATION TECHNOLOGIES2HIM 1800 - PROFESSIONAL PRACTICE EXPERIENCE I2HIM 2234 - ADVANCED ICD CODING AND REIMBURSEMENT3HIM 2283 - ADVANCED CPT CODING & REIMBURSEMENT3HIM 2810 - PROFESSIONAL PRACTICE EXPERIENCE II2TOTAL CERTIFICATE HOURS34

Skills

Skills

Medical Coding