Office Coordinator Patient Access

Tonjau Wyatt

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

SUMMARY

Highly skilled Patient Access Specialist and Healthcare Administration Professional with 12+ years of experience in prior authorizations, insurance eligibility, appeals, grievances, and EMR systems. Proven ability to manage high-volume inbound/outbound calls (60+ daily), resolve complex authorization issues, and streamline operational workflows. Adept at building strong provider relationships, improving patient outcomes, and enhancing overall efficiency within healthcare settings.

WORK EXPERIENCE

CCD Strategic Solutions — Office Coordinator

Nov 2021 – Present

• Coordinate daily operations to ensure alignment with company policies and procedures.

• Facilitate communication with management and staff regarding healthcare benefits and oversee the selection process for company-wide healthcare plans.

• Manage incoming calls, meeting requests, event coordination, and travel arrangements for executive leadership.

• Improve workflow efficiencies by implementing effective scheduling and task management systems.

Community Health Choice — UM Precert Coordinator

Nov 2020 – Aug 2021

• Secured prior authorizations and precertifications from payors by collecting and reviewing patient data within EMR systems.

• Managed 60+ inbound and outbound calls daily, assisting providers, patients, and internal teams with authorization inquiries.

• Processed appeals and grievances accurately, ensuring compliance with state and federal guidelines.

• Enhanced departmental productivity by improving documentation processes and resolving complex authorization issues.

WellCare — Network Relations Consultant

Mar 2020 – Aug 2020

• Built and maintained strong provider relationships through consistent on-site visits and clear communication of administrative updates.

• Delivered education and training to providers regarding policy changes, claims processes, and network requirements.

• Resolved provider concerns efficiently, contributing to improved satisfaction and stronger partnerships.

Anthem — Utilization Manager (Non-Clinical)

Nov 2013 – Aug 2018

• Oversaw non-clinical utilization processes, ensuring authorizations were completed accurately and on time.

• Supported provider and member needs by streamlining workflows and coordinating with clinical teams.

• Assisted in developing strategies to expand referral sources and enhance organizational profitability.

• Strengthened community relationships to increase brand visibility and foster member engagement.

Amerigroup — Claims Analyst

Apr 2012 – Oct 2013

• Analyzed medical insurance claims to verify eligibility, accuracy, and compliance with policies.

• Performed risk analysis and investigative research, ensuring timely and accurate claim resolutions.

• Collaborated with cross-functional teams to enhance claims processing accuracy and improve provider satisfaction.

Amerigroup — Sr. Care Specialist Team Lead

Jun 2010 – Mar 2012

• Managed daily operations of the care specialist team, assigning tasks and ensuring quality standards were met.

• Handled appeals and grievances, ensuring proper documentation and compliance with healthcare regulations.

• Managed EMR updates and maintained accurate patient records.

• Handled 60+ inbound/outbound calls daily to assist providers, members, and internal departments.

• Trained and mentored team members, improving efficiency and reducing processing errors.

EDUCATION

Mary Brantley Smiley High School — High School Diploma

SKILLS

• Prior Authorizations & Precertifications • Appeals & Grievances • EMR Systems (Epic, Citrix, Facets, Jiva, QNXT)

• Insurance Eligibility & Claims Processing • High-Volume Call Management (60+ daily)

• Provider & Patient Relations • Documentation & Compliance • Staff Education & Training

• MS Office Suite • SAP • Creative Problem Solving • Contract Negotiation • Medical Terminology

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