Data Entry Prior Authorization
Resume:
TRACY HAWKINS
*************@*****.***
Birmingham, AL 35215
Summary
To obtain a professional career that will utilize my communication, training, analytical, interpersonal and computer skills. Creative and artistic collaborator. Resolute and well-rounded to providing exceptional services, skilled multitasker comfortable juggling competing priorities. Extremely Dependable, Diligent worker, Punctual, Accurate, adapts quickly and takes pride in everything I do.
Experience
Palmetto Infusion
Birmingham, AL
AccuRx-Case Manager
Responsible for timely acceptance and completion of new patient referrals including insurance verification, prior authorization, and predeterminations as needed for infusion services.
Research and make determinations as to whether patients meet medical necessity for coverage per insurance and/or FDA medical guidelines.
Research and interpret multiple insurance plans member and contract eligibility.
Obtains patient data (medical records, demographic, insurance) from referring MD's office and enters documentation into EMR that supports approval or denial of treatment.
Communicate with patients to schedule appointments and discuss their estimated out-of-pocket monetary responsibility.
Reconcile and balance patient accounts according to explanation of-benefits and patient payments.
Knowledge of ICD-10 & CPT coding.
Assist with training new staff.
Submit and receive medical information from outside sources applying the Health Insurance Portability and Accountability Act
(HIPAA) rules and regulations.
Drury Inn & Suites Hotels
Birmingham, AL
Kickback Bartender & Guest Services
03/2021 – 01/2025
Managed bar area, cocktail design and menu and managed inventory, regulation compliance and customer relationships.
Recommended food and drinks to patrons based on preference, pairings, and special promotions.
Kept track of bar tabs and transferred open tabs to dining area for serving staff.
Stayed up to date on latest mixology trends, bar equipment and sanitation standards.
Maintained knowledge of bar and menu options to prepare drinks and make food recommendations.
Completed regular bar inventories and daily requisition sheets.
Mixed and served both alcoholic and non-alcoholic drinks for patrons by following standard recipes and procedures.
Followed alcohol awareness procedures for preventing intoxication and managing intoxicated guests.
Prepared cocktails from bar recipes and served wine, draft, and bottled beer.
Checked identification of guests to verify age requirements for alcohol purchase.
Poured wine, beer, and cocktails for patrons.
United States Census Bureau
Birmingham, AL
Census Field Taker
04/2021 - 09/2021
Located and approached households and requested participation in census interview, thoroughly explaining process and purpose.
Explained survey functions and objectives.
Returned to houses to obtain additional information or resolve survey issues, politely expressing appreciation for cooperation.
Promoted census significance and rights of participation to prospective interviewees through follow-up calls or in-person visits to address non-responsive initial interview.
Generated accurate and complete reports and case summaries and compiled work records, including required statistics.
Studied maps of assigned areas to plan efficient routes, reaching twenty plus community households per day.
Contacted assigned citizens through mail, email, or phone to obtain and correct census data.
Maintained tight deadlines to support attainment of project schedules.
Compiled and reviewed team questionnaire submissions for completeness and accuracy at end of each day, marking incomplete or problematic surveys for further evaluation.
Addressed non-responsive initial interviews by informing census interviewees on importance of rights of participation.
Aided non-English speakers in translating census materials, verifying comprehension.
Met daily with supervisor to discuss and report results.
Cahaba GBA /Blue Cross Blue Shield of
Alabama Birmingham, AL
Medicare Correspondence Representative
07/1989 - 02/2018
Medicare Part B
Appeals/Review, Responsible for the timely and accurate review of Medicare Part B
Screening average of 300+ appeals per week
Respond to written inquiries from Providers and Beneficiaries
Interpret, analyzing identify how claims processed and evaluating additional information to solve problems.
Knowledgeable of Medicare's and Medical Review Guidelines and claims
processing policies and procedures
Communicate with other departments to solve customer concerns.
Dunn Construction Co Birmingham, AL
Receptionist/Switchboard Operator
02/1986 - 06/1989
Maintained daily calendars, set appointments with clients, planned daily office events.
Sorted incoming mail and directed to correct personnel each day.
Keying and balancing payroll into system
Making all necessary adjustments, reconciling, and balancing invoices from Subcontractors
Letter Proposals for Project Managers.
Scheduled and confirmed appointments.
Answered and directed incoming calls using multi-line telephone system.
Accomplishments & Skills
Registered Medical Assistant - Certification
Skills & Related Capabilities, Toastmaster International
Successfully completed CEU computers courses.
55-75 WPM/10-key number pad/calculator/195 Digits Per Minute
Medical Terminology, ICD-9, CPT-4
Excellent written & Communication Skills, Proper Grammar and
Knowledge of Microsoft Word, Excel, PowerPoint, MRO, HIMR,
MCS (Multi-Carrier System) PEGA System
Maintain Accounts Payable, Customer Accounts, Payroll, Adjustments, Reconciling, Inventory Setup
Organizing and Multi-Tasking, Leadership Abilities, Excellent
Communication Skills
Available upon Request
Languages
English:
Professional
Activities and Honors
Toastmaster Competent Communicator
Exceptional Achievements
Public Speaking and Leadership Skills
Confident Speaker, Communicator, and Leader
Self-Awareness
Certifications
Drury Hotel Anti-Trafficking Training - 2021
2022 F&B Re-Certification Spring Quiz
ServSafe Portal
Spring 2022 Alcohol Compliance
Skills
Proficient in mixology Extensive spirits knowledge
Safe serving knowledge Maintaining glassware stock.
Education and Training
Banks High School Birmingham, AL
High School Diploma
05/1982
Jefferson State Community College Birmingham, AL Degree not completed
Birmingham College of Allied Health Birmingham, AL
Registered Medical Assistant (RMA) in Medical Assisting
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