TERSA TYE

• - Process patient billing, claims, and data entry with high accuracy and attention to compliance
• - Submit and track claims, improving reimbursement timelines and reducing denials
• - Resolve billing discrepancies and communicate with payers to expedite payments
• - Maintain compliance with billing regulations and payer requirements
• - Assist with reporting and analysis related to billing and revenue cycle processes
• Researched and resolved billing discrepancies to enable accurate billing.
• Identified, researched, and resolved billing variances to maintain system accuracy and currency.

• - Led and trained a team of authorization specialists, improving workflow efficiency and team performance
• - Managed end-to-end authorization processes, ensuring compliance with insurance and regulatory standards
• - Conducted audits to identify errors and implement corrective actions, reducing delays
• - Acted as liaison between staff and leadership, supporting communication and operational improvements
• - Monitored performance metrics and supported staff development initiatives
• Established key performance indicators to track team performance and drive accountability.
• Promoted a positive work environment by fostering teamwork, open communication, and employee recognition initiatives.

- Verified insurance eligibility and ensured compliance with payer guidelines

• Streamlined workflow procedures, reducing turnaround time for authorization decisions.
• Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.

- Maintained detailed records to support compliance and audit readiness

• Analyzed medical records and other documents to determine approval of requests for authorization.
• Utilized multiple payer portals, including commercial and state Medicaid systems, to process and manage prior authorization requests
• Processed prior authorization requests efficiently to ensure timely delivery of medical equipment.

• - Managed client inquiries, order processing, and coordination with healthcare providers
• - Maintained accurate records and ensured compliance with industry standards
• - Collaborated with internal teams to ensure timely service delivery
• scheduled delivery of equipment wit technicians and in-house service repairs
• Provided excellent customer care by responding to requests, assisting with product selection and handling ordering functions.
• Collaborated with cross-functional teams to improve service processes and enhance customer satisfaction levels.
• Analyzed customer feedback trends to identify areas for process improvement and increase efficiency.
• Managed high call volume while maintaining a courteous and professional demeanor.
• Addressed customer complaints and mitigated dissatisfaction by employing timely and on-point solutions.
• Developed rapport with customers, fostering long-term relationships and repeat business.

• - Managed patient intake processes, including verifying insurance, updating personal records, and ensuring accurate data entry
• - Collected copayments and processed transactions in compliance with healthcare billing procedures
• - Scheduled appointments and coordinated referrals to support efficient patient care
• - Scanned and maintained insurance documentation in compliance with healthcare regulations
• - Served as a primary point of contact for patients, delivering professional communication and support
• - Collaborated with clinical staff to streamline front-end operations and improve patient experience
• - Supported high-volume patient flow while maintaining accuracy and efficiency