Medical Insurance

Tanya C. Thorn

****-* ********** ******* *****

Charlotte, NC 28262

aca5z1@r.postjobfree.com

336-***-**** Cellular

SUMMARY:

Medical administrative professional with over 20 years of medical office experience, recognized for Medical Front

Office leadership in building and ensuring an extensive patient-centric support between client and patient

relationships while providing billing oversight, medical records coordination and following office policies and

procedures to achieve patient and business success.

WORK HISTORY:

Triad Dermatology Winston Salem, NC

Job Description: Front Office Supervisor & Insurance & Billing Coordinator Nov. 2010-June 2013

Supervise front office staff of four by coordinating schedules and providing coverage as needed •Advise Practice

Manager of issues and works to resolve them •checking patients in and out for medical office visits, nurse visits and

spa services •verify insurance, answering incoming calls, initiate patient reminder calls, scheduling appointments,

handling patient request such as refill on medications and acquire prior approval for medications •iPLEDGE

•collects all payments from patient •receiving and sending faxes and medical records with signed consent to ensure

HIPAA compliance •answer billing and insurance questions from employees and patients regarding insurance

payment status and collection procedures •processes medical claims by matching correct procedural, diagnostic and

modifier codes to electronically transmit and mail HCFA claims to insurance companies for payment of services

•work daily insurance denials through EDI reports •posts all insurance payments on same day as received •follow

up on unpaid insurance claims and signed payment plans •collection calls on patient accounts followed by reminder

collection letters •process patient and insurance refunds, run and analyze reports for Accounts Receivable •acts as

back up for Practice Manager •run financial reports from previous business day and report to physician •configure

payroll and daily bank deposits •Patient Advocate for complaints, concerns with patient care and billing questions

•Staff Recruitment/Training/Evaluation •Vendor Relations •Inventory Management •HIPAA Officer •opens and

closes office and assist clinical area when needed.

Duke University Eye Center Durham, NC

Job Description: Staff Administrator March 2008- Nov. 2010

Hands on Manager of five front office receptionist •checking patients in and out for medical office visits,

appointment scheduling, follow up communications, records management and departmental policies and procedures

•manage all administrative office functions for two physicians •resolves any medical-administrative issues and keep

lines of communication open with other Eye Center departments to ensure high employee morale and a professional,

healthful clinic atmosphere •Provided leadership in developing, planning and implementing the clinic's business

plans to the Physicians •Recommended, developed and implemented improvements for the practice •Informed

Physicians about current trends, problems and medical activities to facilitate policy making •Established and

implemented clinic operating policies and procedures. Participated and coordinated the physician, fellow and

resident recruitment and schedules •Oversees the business and financial affairs of the clinic and enhances

operational effectiveness, emphasizing cost containment without jeopardizing important innovation or quality of

care •Represented the clinic in its relationships with other health organizations, government agencies, and third party

payers and served as liaison and channel of communication between the hospitals, health plans, insurance companies

and regulatory bodies •Physician credentialing• Administration Financial Reporting •Maintenance of clinic

schedules for physicians and clinical service.

Tanya C. Thorn

9543-F University Terrace Drive

Charlotte, NC 28262

aca5z1@r.postjobfree.com

336-***-**** Cellular

Piedmont Ear, Nose, Throat & Associates Winston-Salem, NC

Job Description: Surgery Coordinator July 2004- Feb. 2008

After three years, promoted to Surgery Coordinator for 3 physicians •schedule hospital outpatient surgeries, pre-

operative and status post appointments, and ensuring physicians were allowed the required time necessary to

successfully complete the surgery •ensure proper CPT and ICD-9 coding for the insurance company, billing

department and to inform patients of their financial responsibilities •prepare surgery information packets and mail

surgery information to patient •Maintain records of all verified procedures to provide to financial counselor •answer

patient questions regarding surgery to ensure compliance and patient understanding •Ensures referrals are valid,

appropriate procedure and diagnosis coding is utilized in the pre-certification and verification process •ensures

payment (i.e. co-payments, deductibles and out of pocket fees) for services rendered were received in advance •back

up for front office and medical records.

Piedmont Ear, Nose, Throat & Associates Winston-Salem, NC

Job Description: Front Desk Receptionist August 2001-July 2004

Key interface provided between patients and medical support staff •Scheduling of new patient and follow up

appointments •initiating reminder calls, receiving phone calls, communication of messages, transferring calls and

triage calls to determine the nature of business and urgency of situation •Collection of payment for services

rendered; co-payments, deductibles and other out of pocket fees •filed correspondence, such as previous office

notes, referring office notes, labs and pathology notes in medical charts in their designated category and according to

chronological order to assist physicians in effectively and efficiently treating patients concerns •verify insurance

referrals •back up for medical records.

EDUCATION:

University of Phoenix Winston-Salem, NC

Health Care Administration May 2005-May 2008

Bachelor of Science Degree

Forsyth Tech Community College Winston-Salem, NC

Accounting August 2001- May 2004

Credits earned

COMPUTER AND ELECTRONIC SKILLS:

Microsoft Word •Excel Spreadsheets •PowerPoint •QuickBooks •e-clinical (EMR) •Medic System •DHIS •Misys

•Lotus Notes •IDX System •Dictaphone •Key board 75+wpm•Data Entry 10 Key 300+kspm•

Personal and professional references available

Contact this candidate