Crystal Betts

Dedicated Healthcare Professional with over 25+ years of experience in medical operations, claims administration, and team leadership. Expert in Referral Management, high-volume Data Entry, and Case Management Systems within value-based care frameworks. Proven ability to utilize Microsoft Office and Web-based Applications to enhance Clinical Solutions and ensure Payment Integrity in complex environments like Workers Compensation.

Team Lead - ROTECH HEALTHCARE - ORLANDO, FL

(2023-09)

• Manage high-volume referral workflows, ensuring 100% accuracy in Data Entry and patient record updates within Case Management Systems.
• Assign employee responsibilities and coach staff on Workflow Automation techniques to enhance team capabilities and speed up processing times.
• Collaborate with internal Clinical Solutions teams and external insurance providers to secure prior authorizations and facilitate value-based care.
• Process materials procurement and maintain compliance records while monitoring financial performance to identify process improvements.
• Synthesize patient equipment data and insurance verification results to resolve issues and improve service delivery outcomes.

Medical Claims Analyst - MPHASIS - NEW YORK, NY

(2022-06 - 2023-05)

• Processed healthcare claims efficiently, ensuring adherence to strict payment integrity guidelines and reducing manual data entry errors.
• Managed claim filings and denial resolutions, utilizing Web-based Applications to facilitate accurate reimbursement and financial reporting.
• Audited billing documentation for compliance and accuracy, synthesizing data to enhance overall claims processing integrity.
• Collaborated with internal departments to analyze and respond to outstanding inquiries, maintaining high standards of clinical documentation.

Special Accounts Liaison/Supervisor - SMS NATIONAL - LONGWOOD, FL

(2014-06 - 2021-10)

• Managed special account operations involving Workers Compensation and clinical documentation, conducting in-depth analysis of high-volume orders.
• Processed prescription overrides and worked exceptions on orders using Microsoft Office and specialized medical database tools.
• Collaborated with physician offices via phone and fax to obtain authorizations, ensuring accurate Data Entry in patient profiles.
• Assigned tasks and provided leadership to the team, managing performance reviews and training on updated Workflow Automation procedures.
• Synthesized quality assurance data to audit billing claims and ensure 100% compliance with financial and clinical protocols.

Customer Service Representative - SAKS FIFTH AVENUE - JACKSON, MS

(2012-10 - 2014-04)

• Managed high volumes of customer inquiries in a fast-paced environment, leveraging Computer Proficiency to resolve complex issues.
• Processed service requests and maintained accurate customer data, exhibiting high attention to detail to minimize errors.
• Collaborated with team members to streamline customer support workflows and maintain a positive company image.
• Synthesized feedback from service interactions to identify common pain points and suggest operational improvements.

Leasing Consultant/Assistant Manager/Recruiter - SOMERSET PLACE APARTMENTS/WOODRIDGE APARTMENTS

(2011-01 - 2011-12)

• Managed tenant relations and property operations, applying knowledge of regulations to ensure owner satisfaction and legal compliance.
• Assigned and trained leasing agents on administrative procedures to enhance team performance and service delivery standards.
• Processed applications and background documentation using Web-based Applications for property management.
• Collaborated with ownership to maintain strong relationships and resolve tenant concerns through effective communication.

Accounts Receivable/Pharmacy Technician/Collection Associate/Recruiter - VITAL CARE HOME THERAPY & DME - CORINTH, MS

(1998-01 - 2011-05)

• Processed accounts receivable and medical records, ensuring precision in Data Entry for medications and clinical equipment.
• Managed inventory control and procurement for DME equipment and medications, maintaining efficient logistics and supply chain operations.
• Collaborated with physician offices to obtain refill authorizations and update patient profiles in accordance with state regulations.
• Synthesized business record indexes and utilized storage systems for rapid retrieval and audit preparation.

High School Diploma - Corinth High School, Corinth, MS (2002-05)