Tyneisha McCladdie
Augusta
Summary
Organized professional knowledgeable in regulatory standards and compliance requirements. Confident Prior Authorization Specialist with a background spent working in medical offices, communicating effectively orally and through writing and developing prior authorization workflows.
Overview
4
4
years of professional experience
2023
2023
years of post-secondary education
Work History
Billing Specialist
Augusta Oncology Associates
07.2024 - Current
- Maintained patient confidentiality and safeguarded medical records to avoid information breaches.
- Increased accuracy of insurance coverage validation by utilizing available tools and resources to verify eligibility requirements quickly.
- Ensured compliance with HIPAA regulations by maintaining strict confidentiality in handling sensitive patient information.
- Maintained up-to-date knowledge of industry trends, regulatory changes, and payer-specific guidelines to ensure accurate processing of requests.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Collaborated with team members to resolve discrepancies in insurance verification, ensuring proper billing practices.
- Updated patient records with accurate, current insurance policy information.
- Developed strong relationships with insurance representatives, facilitating smooth communication channels for resolving inquiries or disputes.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
Biologics Coordinator
Harmonie Medical Dermatology
06.2023 - 04.2024
- Trained new team members in biologics handling and processing procedures, fostering a collaborative work environment.
- Developed and executed validation protocols for new equipment, ensuring proper operation and compliance with industry standards.
- Supported continuous improvement initiatives by actively participating in lean manufacturing workshops and trainings.
- Assessed risks associated with various aspects of biologic production processes to mitigate potential hazards effectively.
- Collaborated with cross-functional teams to optimize biologics production processes.
- Established strong working relationships with vendors and suppliers to secure high-quality materials at competitive prices.
- Maintained accurate records of all biologics samples, guaranteeing traceability throughout the process.
- Assisted in troubleshooting complex issues within the biologics process, contributing to swift resolutions and minimal downtime.
- Streamlined workflow for increased productivity and efficiency in the lab environment.
- Identified opportunities for cost savings in the biologics production process, leading to reduced overhead expenses without compromising quality.
Sales Manager
Inspiration Company
07.2022 - 06.2023
- Handled customer relations issues, enabling quick resolution, and client satisfaction.
- Increased sales revenue by developing and implementing effective sales strategies.
- Maintained relationships with customers and found new ones by identifying needs and offering appropriate services.
- Built long-lasting client relationships through excellent customer service and consistent followups.
- Led a successful sales team by providing motivational coaching and performance-based incentives.
- Managed key accounts with strategic planning and relationship building, resulting in increased customer loyalty and repeat business.
- Analyzed market trends to identify new business opportunities, leading to expansion into profitable territories.
- Organized regular sales meetings to review progress, share best practices, and set achievable targets for continued success.
- Consistently met or exceeded quarterly sales targets through diligent effort and persistence in closing deals.
Education
Associate - Medical Billing And Coding
Ultimate Medical Academy
Clearwater, FLBachelor Of Science - Health Administration
Western Governors University
Salt Lake City, UTSkills
- Insurance verification
- Medical terminology
- HIPAA compliance
- Process optimization
- Problem solving
- Team collaboration
- Effective communication
- Attention to detail
- Training and development
- Billing cycle management
- Ttime management
- Revenue cycle management
- Medical billing expertise
Personal Information
Title: Medical Billing Specialist
Timeline
Billing Specialist
Augusta Oncology Associates
07.2024 - Current
Biologics Coordinator
Harmonie Medical Dermatology
06.2023 - 04.2024
Sales Manager
Inspiration Company
07.2022 - 06.2023
Associate - Medical Billing And Coding
Ultimate Medical Academy
Bachelor Of Science - Health Administration
Western Governors University