TANGERYNE M. FARLEY
**** ********* **., ************, **** 43068 Phone: 614-***-****
**********@*****.***
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