TANGERYNE M. FARLEY

**** ********* **., ************, **** 43068 Phone: 614-***-****

ac91hp@r.postjobfree.com

EXECUTIVE PROFILE

Motivated and dependable professional with years of expertise in fast-paced environments utilizing excellent customer relations and administrative functions. Proficient in job execution and proven track record of success in compliance and organizational skills.

STRATEGIC AND CREATIVE THINKER with solid background in delivering decisive, action-driven leadership. Demonstrates expert insight and proficiency in teaching, coordinating, monitoring, evaluating and communicating clients.

RESULTS-ORIENTED PROFESSIONAL with proven capacity to manage and coordinate operations and administrative support, using initiative, resourcefulness and good judgement.

PERFORMANCE-DRIVEN TEAM PLAYER with excellent interpersonal skills and attention to detail, optimally utilizing all channels of communication to assist operations.

CORE COMPETENCIES

Microsoft Office

Reports/Documentation

Client Relations

Administrative/Clerical Skills

Analytical Skills

Communication Skills

Attention to Detail

Problem Resolution

Team Management

Data Entry

Medical Terminology

Numeric Codes/Diagnosis Procedure

PROFESSIONAL EXPERIENCE

MOLINA HEALTHCARE SERVICES (MHS) 09/2018-CURRENT

JOB TITLE: CARE REVIEW PROCESSOR

Works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential

Ensures that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service

Answers calls from providers to assist with prior authorization requests, Peer-to-Peer reviews, gave information regarding denied prior authorization requests, faxed prior authorization approvals, checked CPT code to see if prior authorization is needed

Provides telephone, clerical and data entry support for the Care Review team, checked voicemails and returned calls to providers as needed

Responsible for computer entries of authorization request/provider inquiries, such as eligibility and benefits verification, provider contracting status, diagnosis and treatment requests, coordination of benefits status determination, hospital census information regarding admissions and discharges, and billing codes

Responds to requests for authorization of services submitted via phone, fax and mail according to Molina operational timeframes

Contacts physician offices according to Department guidelines to request missing information from authorization requests or for additional information as requested by the Medical Director

VOCA STAFFING 2017-2018

JOB TITLE: CLINICAL DATA ENTRY CLERK

Demonstrates efficiency by performing procedures rapidly and with accuracy, manages time appropriately, strives to meet departmental goals for daily completion time

Process expedites while paying attention to details, resolves issues for members and providers, group administrators and brokers

Assists with navigating, maintaining, organizing and extracting clinical/medical information from test requisition forms

Reviews data for deficiencies or errors, and correct any incompatibilities if possible

Takes inbound calls from members and/or providers seeking assistance and ensuring they are transferred to the correct person or department

Understands and recognizes laboratory information system alerts and flags and takes the appropriate actions

Recognizes when information presented on requisitions is unclear and ambiguous and knows and follows corrective actions to be taken

Participates in departmental quality assurance practices, acts as a resource to others who require assistance/training

Respects and maintains the confidentiality of information relative to clients and patients

Utilizes job knowledge, judgment and problem solving skills to ensure quality of work

RELIANT CAPITAL SOLUTIONS 2016-2017

JOB TITLE: ADMINISTRATIVE SPECIALIST

Assisted various departments by reviewing and auditing income statements, calculate discretionary income using tax returns, paystubs and expense statements

Reviewed and audited financial documents received to ensure accuracy and completion per Department of Education requirements

Processed billing in accordance with Department and Education requirement, ensured timely processing of documents per Department standards

Responsible for researching and preparing special reports, examining and verifying documents, and performing general office duties

Created documents in Microsoft Word, Excel, and Publisher, typed and proofread various documents using correct grammar and spelling

Prepared travel requests and reimbursement forms for faculty and students, processed the paper work for new hires and process position termination workflow

REPUBLIC AIRWAYS 2012-2016

JOB TITLE: PRODUCTION CONTROLLER

Obtained and audited work packages while working with Production Management to issue paper work compliance

Responsible for hiring, feedback, development, recognition, discipline, orientation and training of all employees

Accountable for managing inventory/material transactions and addressing material shortages, backlogs, or other potential schedule interruptions that could impact the production schedule

Planned, scheduled, and issued work order instructions to the production floor in accordance with the production schedule ensuring a quality product in a timely manner

Managed and evaluated maintenance needs and made recommendations for new equipment and design changes helping to improve safety and increase efficiency resulting a reduction in operating costs

INTERMEDIX 2010-2010

JOB TITLE: PATIENT ACCOUNTS REPRESENTATIVE

Answered inbound inquiries from customers about EMS accounts, entered insurance information and processed telephone payments. Educated patients on EMS services

Monitored all delinquent accounts and managed collection activities, assisted to resolve billing issues for customers through regular inquiries

Arranged for payments to be made by debtors via telephone, sending statements to debtors, insurance companies, and attorneys in accordance with established policies and procedures.

Served as patient advocate during the entire cycle of the account through telephone, mail, and research efforts, Medicare Collector/Billing

Identified authorization, cash posting, and registration errors on patient accounts and route to the appropriate department for correction

EDUCATION/ACHIEVEMENT

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