Patient Access Insurance Verification

Tamara M. Mason

Houston, TX ***** 713-***-**** *******@*****.***

Professional Summary

Highly motivated and detail-oriented Insurance Verification & Authorization Specialist with over 10 years of experience in patient access, revenue cycle management, and insurance coordination. Proven expertise in Medicare/Medicaid, commercial, and exchange plans, with a strong track record of securing timely authorizations, reducing claim denials, and enhancing patient satisfaction. Adept at navigating complex EMR systems (Epic, IDX, Allscripts) and fostering effective communication between patients, providers, and insurers. Seeking to leverage expertise to support healthcare organizations in optimizing patient flow and reimbursement accuracy.

Core Competencies

• Insurance Verification & Benefits Coordination

• Prior Authorization & Referral Management

• Medicare, Medicaid, & Commercial Plans

• Patient Access & Financial Counseling

• EMR Systems (Epic, IDX, Allscripts)

• HIPAA Compliance & Confidentiality

• Revenue Cycle Optimization

• Patient & Physician Communication

• Microsoft Office Suite Data Entry Outlook

Professional Experience

UT Health Houston – Houston, TX

Insurance Verification Authorization Specialist III Mar 2020 – Aug 2025

• Verified insurance eligibility, benefits, and patient responsibility (co-pays, deductibles, coinsurance) via online portals, insurer contact, and EHR systems.

• Processed 50+ prior authorizations weekly, ensuring compliance with payer requirements.

• Achieved a 98% approval rate for authorization submissions by providing accurate clinical documentation.

• Communicated patient financial responsibility upfront, reducing billing disputes and increasing collections.

• Ensured accurate and timely updates in EMR and practice management systems.

• Acted as liaison between patients, providers, and insurers to expedite care and approvals.

Insperity / UT Physicians – Kingwood, TX

Sr. Patient Access Representative – Insurance Verification Dec 2017 – Mar 2020

• Verified and updated insurance, demographic, and financial information in GECB system.

• Confirmed patient eligibility prior to scheduled services, minimizing last-minute cancellations.

• Maintained strict confidentiality and compliance with HIPAA standards.

• Supported physicians and staff by resolving insurance discrepancies in real time.

UT Health – Houston, TX

Sr. PAR / Insurance Verification Specialist Mar 2015 – Dec 2017

• Managed full-cycle insurance verification, referral, and authorization processes.

• Informed patients of estimated out-of-pocket costs, improving financial transparency.

• Scheduled patient appointments, managed demographics, and ensured accurate billing codes.

• Reduced claim rejections by proactively updating financial status codes (FSCs).

• Supported OB patients by setting up global obstetric contracts.

Insperity / UT Physicians – Kingwood, TX

Patient Access Representative I Sep 2013 – Feb 2015

• Collected and entered demographic, insurance, and financial information with 99% accuracy.

• Secured required documentation, forms, and signatures during patient check-in/out.

• Verified insurance eligibility both before and at time of service.

• Contributed to reducing financial losses by ensuring accurate insurance capture.

Education

Associate of Arts in Multispecialty – Houston Community College (2019)

High School Diploma – St. Pius X High School, Houston, TX (1992)

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