Glenn Tangela
Harrisburg,NC
Summary
Dynamic Precertification Specialist with extensive experience at Carolina Neurosurgery & Spine Associates, adept at securing timely authorizations and enhancing patient satisfaction. Skilled in insurance verification and conflict resolution, I successfully facilitated appeals for denied services, demonstrating professionalism and a commitment to patient care excellence.
Overview
17
17
years of professional experience
Work History
Precertification Specialist
Carolina Neurosurgery & Spine Associates
01.2018 - Current
- Coordinated precertification processes to ensure timely authorizations for patient procedures.
- Reviewed medical documentation for accuracy and compliance with insurance requirements.
- Collaborated with clinical teams to streamline workflows and enhance patient care efficiency.
- Educated staff on precertification guidelines and best practices to improve departmental knowledge.
- Facilitated successful appeals for denied services by providing detailed documentation supporting medical necessity as required by insurers.
- Elevated patient satisfaction by offering compassionate guidance and support during the often-stressful precertification process.
Patient Service Representative
Lash Group
08.2017 - 12.2018
- Managed patient inquiries, providing timely and accurate information to enhance service experience.
- Verified insurance eligibility and coverage for patients.
- Handled sensitive patient concerns with professionalism and empathy, fostering an atmosphere of trust within the clinic.
- Filed and maintained patient records in accordance with HIPAA regulations.
- Managed patient registration process, confirming data accuracy and completeness.
- Built and maintained positive working relationships with patients and staff.
Precert Coordinator
Carolina Digestive Health Associates
04.2009 - 06.2018
- Obtained authorizations for both outpatient surgeries and radiology procedures.
- Obtain patient eligibility from health plans for coverage
- Made patient aware of out of pocket expenses needed for the Ambulatory Surgery Center.
- Filed and maintained patient records in accordance with HIPPA regulations.
- Obtained authorizations for biologic meds such as for gastrointestinal diseases
Education
High School Diploma -
Redford High School
Detroit, MI06-1978
Skills
- Prior authorization
- HIPAA compliance awareness
- Documentation and paperwork
- Collaboration and teamwork
- Multitasking Abilities
- Insurance verification expertise
- Professionalism and ethics
- Conflict resolution techniques
Accomplishments
I have my own Non-Profit 501c3 in which we feed, and clothe the homeless community. We have been able to provide full Turkey gift boxes for the Thanksgiving holiday as well as provide blankets for the winter months to help keep the community warm while dealing with terrible weather conditions.
We provide gift boxes to individuals that are ready to move in homes after coming out of homelessness on there own with cleaning supplies, dishes, and other necessary items.
Timeline
Precertification Specialist
Carolina Neurosurgery & Spine Associates
01.2018 - Current
Patient Service Representative
Lash Group
08.2017 - 12.2018
Precert Coordinator
Carolina Digestive Health Associates
04.2009 - 06.2018
High School Diploma -
Redford High School