Catherine Brotherton

Serve as Team Lead for financial counseling operations, providing daily guidance and support to ensure accurate and timely billing and insurance processes. Act as an escalation point for complex billing and insurance issues. Estimate patient financial responsibility for uninsured and high-deductible plans. Verify insurance eligibility using Phreesia and payer portals. Review EOBs to ensure billing accuracy and compliance with payer guidelines. Enroll patients in assistance programs to reduce out-of-pocket costs and obtain prior authorizations for surgical and in-office procedures.

Key Accomplishments as Team Lead:

• Trained and supported team members on insurance verification, EOB review, and patient financial communication
• Improved consistency and accuracy of patient estimates and insurance workflows
• Assisted with onboarding and mentoring new hires
• Reduced billing errors by proactively reviewing complex cases prior to submission
• Maintained high productivity and turnaround times in a fast-paced, high-volume environment while balancing leadership responsibilities

• Estimating amounts owed for uninsured/ high deductible patients
• Verifying insurance on Phreesia/Payer Portals
• Reviewing EOBs for accurate billing to patients per insurance guidelines
• Signing patients up for assistance programs to help them with their out of pocket cost towards their injections
• Contacting patients regarding out of pocket costs for surgeries/office visits
• Receiving authorizations in a timely manner for surgeries and in office procedures

• Investigated incorrect billings and processed refunds as necessary.
• Monitored accounts receivable activity to ensure timely payment of invoices.
• Calculated billing charges, prepared and submitted claims to insurance companies
• Verified insurance coverage and identified third-party payers for billing purposes.
• Maintained accurate records of collections, adjustments and denials in the system.
• Verified accuracy of charge information prior to posting.
• Researched and resolved billing discrepancies in a timely manner.
• Processed credit balance adjustments, refunds, write-offs, denials and appeals

• Set up patients in system by documenting key data, confirming eligibility and verifying insurance benefits.
• Creating paper charts for new patients with all paperwork needed for surgery
• Collected payments and co-pays from customers using large variety of insurance programs, adjusting amounts based on specific plan directives.
• Accurately inputted patient and insurance information into company's computer system using Software.
• Explained financial responsibilities to patients as well as payment options and potential collection procedures imposed upon patients and other responsible parties.

• Checked in and checked out patients in a quick and efficient manner
• Answer multi telephone system and triage phone calls for back staff
• Schedule patients for appointments and surgery
• All medical records for the office as well as chart audits requested by insurance companies
• Post payments according to copays coinsurance or deductibles and balance the end of day and make sure all money matches

• Greeted guests at front desk and engaged in pleasant conversations while managing check-in and check-out process.
• Answered multi-line phone system to respond to inquiries and transfer calls to correct departments and personnel.
• Resolved customer issues quickly and notified supervisor immediately when problems escalated.
• Maintained files and records by implementing effective filing systems that boosted efficiency and organization.

• Reviewed accounts on monthly basis to assess aging and pursue collection of funds.
• Contacted clients with past due accounts to formulate payment plans and discuss restructuring options.
• Prepared and mailed invoices to customers, processed payments and documented account updates.
• Identified, researched and resolved billing variances to maintain system accuracy and currency.
• Experience reading EOBs and posting insurance payments to patient accounts

• Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
• Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
• Informed customers about special promotions and provided detailed information for various products.
• Developed and actualized customer service initiatives to decrease wait times.