Andrea Compton Email & Phone Number

Franklin, TN

• Load ("programs") executed managed care contracts into the contract management system
• Update contracts with scheduled rate changes as of effective dates
• Build new service definitions and implements new reimbursement methodology into the system as required
• Consult with contract negotiators to recommend precise language and meaning of contracts to ensure that the contract template accurately calculates the terms of the contract as negotiated
• Monitor periodic changes in recognized coding schemes (ICD, CPT, and DRG) to anticipate on contract language, calculations and reimbursement of specific contracts using those codes
• Perform other related duties as assigned or requested

Franklin, TN

• Identify trends in underpayments/overpayments and denials
• Interpret contract reimbursement and provide feedback to management
• Manage underpayment appeals, account follow up and payer relationships
• Review payer policies for impact on reimbursement
• Present data to various end users
• Compile and validate account analysis prior to distribution

Franklin, TN

• Analyze and evaluate worker’s compensation claims
• Request and acquire all needed medical records, implant invoices and any other supporting documentation
• Conduct follow-up telephone calls with worker’s compensation insurance companies to ensure claims are being paid within the allotted timeframe and are being paid correctly per the state fee schedule
• Prepare the initial claim packet to be sent to the insurance company.

Columbia, TN

• Oversee and manage all Customer Service Representatives
• Verify multiple insurances to ensure co-payments and deductibles
• Deal with numerous worker’s comp insurance companies to accept payment and work on pricing agreements for equipment
• Make sure all referrals are worked timely and all referral sources are happy with our services
• Maintain a working relationship with marketers and their referrals sources
• Prepare and run daily reports

• Held key responsibility in ordering money from the Federal Reserve and shipping money to the Federal Reserve
• Served as a customer relations specialist. Help customers with any questions they had regarding their account
• Initiated investigations if a customer claimed fraudulent charges on his/her account

Bachelor Of Business Administration (Bba), Marketing

General Transfer, General Transfer