Anntwanette C. Email & Phone Number

Marietta, Ga

Research and answer escalated inquiries as it relates to medical verification's of insurance policies, coding, billing, and claims. Assist team members with securing authorizations and approvals. Guide team members to meet daily productivity goals set by management team. Mentor and counsel team members for accuracy and efficiency in processes and results. Adhere to all applicable policies, procedures, processes and systems in order to optimize the maximum reimbursement levels.

Greater Atlanta Area

Provided customer and system support for integrated Clearwave clients nationwide that utilize NexGen,Centricity, Allscripts, Greenway, Availity, Medicare and other EHR/EMR /Billing and practice management systemsManaged all support personnel through performance management processes, including performance reviews,regular feedback on personal goals, meeting company goalsOversaw all service requests, as well as managing the assignment, tracking, escalation and completion of requestsDeveloped new process for employee evaluation which resulted in marked performance improvements.Devised and published metrics to measure the organization\'s success in delivering world class customer service.Followed-through on all critical inter-departmental escalations to increase customer retention rates.

Alpharetta, Ga

Promptly reviewed and resolve internal/external customer escalations, questions and concernsWorked with departmental heads and team members to update SOP's and communicate new/revised policies appropriately ensuring up-to-date current information is circulatedOversaw daily office operations for staff of 17 employees.Compiled and drafted 2 team case load reports each week.Recruited, hired, trained and coached on average of 4-5 new employees per year while maintaining 98% retention rate.Correctly coded and billed medical claims for various hospital and nursing facilities

Alpharetta, Ga

Verified ICD codes are appropriate for billing using code books and Zirmed.Actively sought ways to effectively maximize headcount to control cost/budgets.Monitored and delegated workload volumes on a daily basis Worked directly with Authorizations and Billing to achieve company revenue goals per month.Recruited, hired, trained and coached on average of 4 new employees per year.Interpreted and communicated new or revised policies to staff.Strategically planned methods to achieve operational goals and targets.

Alpharetta, Georgia

The Team Lead supported a team of 8+ employees.Recruited and trained 4 new hires while maintaining our 98% retention rateContributed to the overall customer service feedback/scores that IPG surveys facilities each quarter resulting in an overall 95% customer stat ratingSkillfully developed departmental goals, objectives, standards of performance, policies and procedures.Interpreted and communicated new or revised policies to staff.Led, designed and implemented training programs and initiatives which contributed to a 15% percent increase in productivity.Analyzed facility and customer feedback to identify opportunities for staff recognition as well as areas for improvement.

Alpharetta Ga

Managed all DME (Durable Medical Equipment) Manager Accounts for Workers Compensation cases from various client integrated EMR systems within the Authorization Department Maintained consistent follow-up with the WC adjusters and DME providers to insure proper and timely filing per company SLA's Managed/Onboard all contracted VIP DME Managers while focusing on maintaining and building existing client relationshipsNegotiated discounted pricing for implants with Nurse Case Managers to lower implant cost which resulted in the overall cost reduction of surgical implant cost Precisely completed appropriate claims paperwork, documentation and system entry.

Atlanta, Ga

Maintained various doctors’ surgical schedules at Children's Healthcare of AtlantaCreated batch insurance verification reports for the deptCoordinate between insurance companies, physician's offices, billing office and patients in regards to obtaining all of the necessary documentation for pre-certification of a visit. Identify insurance plans that need to have an authorization / referral and submit appropriate authorization / pre-certification documentation to obtain an approval.Input required authorization / pre-certification information into system(s) Maintains consistent follow-up with the insurance companies on the status of all prior authorization requests Review authorizations from the payers to determine if they are approved or denied for (Medicaid./Medicare/All healthcare plans)Onboarded various PhysiciansManaged Physicians Credentialing/Contracting processesPerformed Op Tech Triage calls Front Desk operations; Check in, Check out when neededProvided over the phone consultations for prospective patientsConducted all in house financing options for surgical procedures (Care Credit and Capital One)Provided financial company reports for Manager and CEOCall and confirm upcoming surgical patient procedures Handle all patients records and payments for all co-managed doctors

Greater Atlanta Area

ResponsibilitiesMaintain two pediatric doctors’ schedules.Schedule multiple surgeries at various hospitals.ICD 9 HCPS/CPTCode Knowledge Insurance verification( Medicaid./ Medicare/All healthcare plans)Identify insurance plans that need to have an authorization / referral and submit appropriate authorization / pre-certification documentation to obtain an approval.Maintained consistent follow-up with the insurance companies on the status of all prior authorization requests Review authorizations from the payers to determine if they are approved or denied. Worked closely with the physician’s offices and providers in regards to potential complications in obtaining an authorization for servicesCoordinate with the Appeals Team in billing on past or retro appointments to provide assistance with appealing denials. Scribe for the doctorProvide complete patient assessment for examsWrite and/or call-in patient refill prescriptions.Schedule CT/MRI scans obtain precert if needed Front Desk operations; Check in, Check out when neededAccomplishmentsKEY ACCOMPLISHMENTS*-Thrived within busy environment, requiring the ability to multi-task and maintain organized atmosphere.-Demonstrated ability to quickly learn organizational processes, workflow's, policies and procedures in themedical field.-Handled a variety hospitals surgery schedules for multiple doctors.-Demonstrated the ability to learn a brand new career and scheduling system very quickly.-Demonstrated knowledge to effectively obtain# Medicaid/ Medicare precerts and authorization's forprocedures.-Effectively earned and maintained the respect of my peers and doctors as a hard working employee.

Southfield, Mi

ResponsibilitiesAssess patient vision.Set up testing, and dilate patient eyes.Write prescriptions.Administer contacts and perform I&R’SSchedule Cataract/Lasik surgeries at various locations.Identify insurance plans that need to have an authorization / referral and submit appropriate authorization / pre-certification documentation to obtain an approval.Answer phones, schedule appointments.Maintain doctor’s on-call schedules, and surgery schedules.AccomplishmentsKEY ACCOMPLISHMENTS*-Demonstrated ability to quickly learn organizational processes, workflow's, policies and procedures in themedical field.-Handled a variety hospitals surgery schedules for multiple doctors.Answered phones and courteously assisted customers with high-volume, deadline-driven settings. Earned areputation for taking care of patients, and giving them my total attention.-Demonstrated the ability to learn a brand new career and scheduling system very quickly