Tanya Smith
Philadelphia,Pennsylvania
Summary
Efficient billing professional with 20 years of experience. Productive and diligent with passion for resolving discrepancies through attention to detail and creative problem-solving. Passionate about perpetuating company values through impeccable work ethic and drive.
Overview
17
17
years of professional experience
Work History
Insurance Specialist
Acclara
03.2022 - Current
- Processed eligibility and benefits verification and authorization requests.
- Followed up on denials, late payments, extensions and other special circumstances.
- Followed up with customers on unresolved issues.
- Generated, posted and attached information to claim files.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Provided exceptional customer service to patients when discussing billing matters, demonstrating empathy and professionalism at all times.
Medical Billing and Collections Specialist
Horizon House Inc
05.2019 - 03.2022
- Check Evs prior to billing monthly services
- Entered all Cbh, and Mbh authorizations
- Preparing, reviewing, and transmitting claims using billing software, including electronic, and paper claims processing
- Verify completeness and accuracy of all claims prior to submission
- Reduced claim denials by diligently reviewing patient records for correct coding and billing information.
- Prevented unnecessary loss of revenue due to late or incomplete billing by meticulously tracking all accounts and ensuring timely submission of accurate claim forms.
- Trained new employees on medical billing software, policies, and procedures, ensuring accuracy in claims submission from day one.
Medical Coder
Mercy Health Systems
06.2017 - 10.2018
- Monitored electronic medical records (EMR)
- Determined prognosis and diagnosis of disease, conditions, and medical procedures
- Utilized CPT, and HCPCS to apply accurate diagnostic procedures
- Managed, and corrected all issues regarding coding errors
- Consulted with healthcare provider in regard to denied services.
Credentialing Specialist
Mercy Health Systems
02.2009 - 06.2011
- Managed healthcare providers credentialing documents
- Monitored physician’s insurance participation
- Processed and regulated current and new insurance registration and practicing affiliation.
Charge Entry Specialist
Mercy Health Systems
09.2007 - 02.2009
- Retrieved billing/medical charges
- Collect all necessary information for entering charge
- Entered charges in database
- Monitored charge entry databases
- Supervised entry level charge specialist.
Education
John Bartram High School
Philadelphia, PA06.1995
Skills
- HIPAA Compliance
- HCPCS Coding
- ICD-10 Knowledge
- Medical Billing Software Proficiency
- Medical terminology
- Clerical/office support
- Data entry
- Advance Microsoft Word, Excel, Office and Access
- Claims Investigation
- Customer Service
- Billing Software
- Denied claims identification
- Coverage Determination
Timeline
Insurance Specialist
Acclara
03.2022 - Current
Medical Billing and Collections Specialist
Horizon House Inc
05.2019 - 03.2022
Medical Coder
Mercy Health Systems
06.2017 - 10.2018
Credentialing Specialist
Mercy Health Systems
02.2009 - 06.2011
Charge Entry Specialist
Mercy Health Systems
09.2007 - 02.2009
John Bartram High School
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