TANISHA COLBERT

Capitol Heights, MD ***** ac2g4z@r.postjobfree.com 240-***-****

OBJECTIVE

As an essential member focused on patient centered treatment, I am looking to help patients feel at ease the physician’s office. Additionally, I am a strong planner and problem solver who readily adapts to change, I am a team player, but can work independently and will exceed expectations. I possess the ability to juggle multiple priorities and meet tight deadlines without compromising quality and organizational integrity.

SKILLS & ABILITIES

CPR & AED Certified Fax Machine Billing

Data Entry Photocopier/Scanner/Printer Referral Tracking

60 WPM Credit Card Machine Benefit Verification

ICD-9 & CPT Coding EHR-Epic & Athena Reimbursement

HIPAA Microsoft Office Multi-line Phone

Medical Terminology Autoclave & Sterilization

EXPERIENCE

REIMBURSEMENT COUNSELOR AMERISOURCEBERGEN

OCTOBER 2016 TO JULY 2017

Responsible for various reimbursement functions, including but not limited to accurate and timely claim submission, claim status, collection activity, appeals, payment posting, and/or refunds, until accounts receivable issues are properly resolved. Collects and reviews all patient insurance benefit information, to the degree authorized by the SOP of the program. Provides assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications. Completes and submits all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third-party payors. Researches and resolves any electronic claim denials. Researches and resolves any claim denials or underpayment of claims. Effectively utilizes various means for collections, including but not limited to phone, fax, mail, and online methods. Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly. Maintains frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers. Reports any reimbursement trends/delays to supervisor (e.g. billing denials, claim denials, pricing errors, payments, etc.). Processes any necessary insurance/ patient correspondence. Provides all necessary documentation required to expedite payments. This includes demographic, authorization/referrals, National Provider Identification (NPI) number, and referring physicians. Coordinates with inter-departmental associates to obtain appropriate medical records as they relate to the reimbursement process. Maintains confidentiality regarding patient account status and the financial affairs of clinic/corporation. Communicates effectively to payors and/or claims clearinghouse to ensure accurate and timely electronically filed claims. Works on problems of moderate scope where analysis of data requires a review of a variety of factors. Exercises judgment within defined standard operating procedures to determine appropriate action. Performs related duties as assigned.

REFERRAL MANAGEMENT CLERK GTW CONSULTANTS & ASSOCIATES, LLC OCTOBER 2015 – AUGUST 2016

Greets patients/visitors at a front desk, referral center or office setting. Answers main office phone line(s). Directs telephone calls to appropriate section for assistance, handles independently or takes messages as required. Reviews referrals for administrative completeness and researches covered benefits prior to processing. Determines patient eligibility for services and arranges and schedules medical appointments for referred care. Provides general instructions to patients and ensures patients have necessary documentation for referred health care services. Obtains updates and files medical records as needed. Organizes and researches patient records, extract needed information, and review records for referral results within established guidelines. Request medical records and ensures arrival of medical records prior to appointment(s). Initiates and locates patient medical records as needed. Obtains documentation as requested by healthcare providers (test results, or documentation not yet filed in records). Ensures referral results are returned to the referring provide and to the medical record within required timelines. Assists with follow up, written or verbal, as necessary. Completes referral tracking data collection tool, calculates metrics, and compiles monthly reports as directed by the MTF. Orients and trains MTF personnel about the referral process and timelines.

MEDICAL ASSISTANT LARGO PRIMARY CARE JUNE 2011 – JUNE 2015

Register and schedule patients, print documents to include the provider's daily schedule; accesses and makes changes to the patient's quick view screen; properly utilizes the patient privacy link, workflow dashboard, and card scanner. Ensures that sufficient inventories of medical and office supplies are stocked and maintained in the office and exam rooms. Able to process the ordering of clinical supplies in accordance with practice standards. Demonstrates an understanding of Quality Assurance/Quality Control standards; completes lab requests, referral and health forms and maintains logs as mandated by state and federal regulatory guidelines, policies and procedures of AAHCE. Administers injections, EKG's, spirometry, perform phlebotomy, and renders therapeutic treatments (practice specific) as instructed by the physician. Understands how to determine patient eligibility using programs such as Medicaid EVS; can consistently identify when a patient needs a referral and/or preauthorization; knows how to search for or add insurances in the practice management system; demonstrates the ability to properly edit a claim. Answers and screens office calls, greets patients in a professional and timely manner; projects proper telephone etiquette; understands when it is acceptable to release patient's protected health information. Accurate, complete, and timely data input within the bounds of record access and in compliance with the processes and procedures governing the electronic health record. Accessing patient record information only as it directly pertains to the performance of work duties. Able to obtain patient vital signs and properly document them in the patient's medical record. Interviews, triages and prepares patients to facilitate smooth flow, assists providers in medical examinations, and provides other general assistance to the provider and staff as necessary. Performs other projects and duties as assigned.

EDUCATION

ASSOCIATES OF SCIENCE OCTOBER 2013 MEDTECH COLLEGE

REFERENCES

AVAILABLE UPON REQUEST