Brenae Carter
Norristown
Work Preference
Summary
Healthcare intake and patient access professional with extensive experience in referral intake, insurance verification, and authorization processing. Successfully managed high-volume workflows, reducing authorization turnaround times by 20%, while ensuring compliance and supporting timely patient care. Skilled in collaboration with clinical teams and proficient in multiple EMR systems.
Overview
11
11
years of professional experience
Work History
Family & Visitor Services Coordinator (Part-Time)
Children's Hospital of Philadelphia (CHOP)
King of Prussia
01.2023 - Current
- Serve as first point of contact for patients and families in a fast-paced pediatric hospital environment.
- Support front-end patient access operations and workflow coordination.
- Respond to high-volume inquiries while maintaining professionalism and compassion.
- Collaborate with clinical and administrative departments to ensure smooth patient flow and operational efficiency.
- Maintain HIPAA compliance and confidentiality of protected health information.
Prior Authorization Specialist
Lymphacare
Montgomeryville
06.2025 - 01.2026
- Managed 50-75+ DME authorization requests daily utilizing Brightree EMR.
- Verified insurance eligibility, benefits, and medical necessity prior to submission.
- Coordinated with payer representatives and provider offices to obtain timely determinations.
- Submitted clinical documentation and maintained accurate authorization records.
- Reduced authorization turnaround time by 20%, supporting efficient patient care and compliant billing workflows.
- Maintained productivity and quality standards in a high-volume healthcare environment.
Reimbursement Specialist / Utilization Review
Main Line Health
Radnor
04.2024 - 06.2025
- Conducted precertification and utilization review activities for Medicare Advantage and commercial insurance plans.
- Processed authorization requests and validated coverage requirements using HomeCare HomeBase EMR.
- Collaborated with clinical teams to secure documentation supporting medical necessity determinations.
- Reviewed payer guidelines to ensure compliance and reduce claim denials.
- Assisted with concurrent and retrospective review processes.
- Maintained accurate payer documentation and authorization tracking.
Patient Interviewer (Contract)
Temple University Hospital
Philadelphia
08.2023 - 02.2024
- Registered patients and entered demographic and insurance information into EPIC.
- Verified insurance eligibility and benefits to support accurate billing and reimbursement.
- Collected and updated patient information while ensuring documentation accuracy.
- Assisted patients with intake-related questions and registration processes.
Patient Services Representative
Penn Therapy & Fitness
Radnor
12.2021 - 05.2022
- Registered patients and verified demographic and insurance information.
- Scheduled appointments and managed high-volume inbound calls.
- Collected co-payments and processed patient financial transactions.
- Supported front-office operations while maintaining confidentiality standards.
Patient Services Representative
Center for Vein Restoration
07.2021 - 03.2022
- Completed patient registration and insurance verification within NextGen EHR.
- Scheduled appointments and facilitated communication between departments.
- Updated patient records and maintained documentation accuracy.
- Collected co-payments and balanced daily financial transactions.
Pre-Certification Coordinator
Chesapeake Urology Associates
01.2021 - 07.2021
- Obtained prior authorizations and precertifications for scheduled procedures and specialty services.
- Verified insurance coverage and payer requirements for outpatient services.
- Coordinated with provider offices and insurance carriers to resolve authorization issues.
- Linked referrals and authorization documentation within Allscripts EMR.
Pre-Encounter Specialist
Main Line Health
01.2018 - 01.2020
- Coordinated referrals and documented insurance eligibility in EPIC to facilitate timely patient access to care.
- Assisted with patient intake preparation and coordinated appointments to streamline office workflow.
- Educated patients on insurance coverage and financial responsibilities, enhancing understanding of their healthcare options.
- Maintained accurate patient and payer documentation.
Patient Service Representative
Penn Therapy & Fitness
Radnor
01.2016 - 01.2018
- Executed patient registration, scheduling, and insurance verification to streamline patient intake process.
- Processed patient payments while ensuring adherence to HIPAA regulations.
- Facilitated patient flow and optimized front-office operations to enhance overall service experience.
Access Scheduler / Front Desk Associate
Axia Women's Health
01.2015 - 01.2018
- Acted as the initial point of contact for patient scheduling and registration.
- Entered insurance information and collected patient payments.
- Maintained confidentiality and professionalism in all patient interactions.
Education
Steptful Pharmacy Technician Certification Program -
06-2025
High School Diploma -
Methacton High School
06-2006
Skills
- Referral Intake & Authorization Processing
- Insurance Eligibility & Benefits Verification
- Prior Authorization & Precertification
- Patient Registration & Scheduling
- Provider & Patient Communication
- Medical Documentation Review
- Revenue Cycle & Billing Support
- Medicare, Medicaid & Commercial Payers
- HIPAA Compliance & Confidentiality
- High-Volume Workflow Management
- EMR Systems: EPIC, Brightree, NextGen, Allscripts, HomeCare HomeBase
- InterQual & MCG Criteria Familiarity
- Patient & Family Support Services
- Work Queue Management & Documentation Accuracy
Timeline
Prior Authorization Specialist
Lymphacare
06.2025 - 01.2026
Reimbursement Specialist / Utilization Review
Main Line Health
04.2024 - 06.2025
Patient Interviewer (Contract)
Temple University Hospital
08.2023 - 02.2024
Family & Visitor Services Coordinator (Part-Time)
Children's Hospital of Philadelphia (CHOP)
01.2023 - Current
Patient Services Representative
Penn Therapy & Fitness
12.2021 - 05.2022
Patient Services Representative
Center for Vein Restoration
07.2021 - 03.2022
Pre-Certification Coordinator
Chesapeake Urology Associates
01.2021 - 07.2021
Pre-Encounter Specialist
Main Line Health
01.2018 - 01.2020
Patient Service Representative
Penn Therapy & Fitness
01.2016 - 01.2018
Access Scheduler / Front Desk Associate
Axia Women's Health
01.2015 - 01.2018
Steptful Pharmacy Technician Certification Program -
High School Diploma -
Methacton High School