Michi Tanniehill
San Antonio,TX
Summary
To obtain a position in a Fortune 500 company that offers enhanced advancement opportunities and will enable me to utilize my skills, experience, and education in a diverse atmosphere.
Overview
25
25
years of professional experience
Work History
Billing Specialist
3m
08.2015 - Current
- Researched and resolved billing discrepancies to enable accurate billing.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Worked with multiple departments to check proper billing information.
- Assisted colleagues in resolving complex billing issues, promoting teamwork and knowledge sharing within the department.
- Maintained strict confidentiality of sensitive information while adhering to company policies regarding privacy protection.
- Performed prior authorization review of services requiring notification.
- Obtained authorizations from multiple insurance carriers for various levels of care.
- Evaluated medical necessity criteria using evidence-based guidelines to ensure that services provided were both clinically appropriate and cost effective.
Insurance Coordinator
WellMed Medical Management - United Health Group
10.2011 - 08.2014
- Verified insurance and communicated coverage to staff and patients.
- Managed a high volume of inbound calls, promptly resolving issues while providing accurate information on policies and procedures.
- Assisted clients with understanding complex insurance policies, effectively addressing concerns or questions.
- Obtained data such as patient, insurance ID, insurance provider and medical codes to properly file insurance claims.
- Obtained prior authorization and precertification for outpatient procedures.
- Assisted in resolving complex insurance claims, liaising between clients and providers for favorable outcomes.
Utilization Review Coordinator
UnitedHealthcare
09.2000 - 08.2011
- Contributed to the development of policies and procedures related to utilization management, ensuring alignment with industry best practices.
- Championed the importance of ethical decision-making within the Utilization Review Department, fostering an environment where all team members felt empowered to advocate for high-quality patient care.
- Streamlined workflows within the department by developing tools and resources aimed at improving consistency in utilization review practices.
- Evaluated medical necessity criteria using evidence-based guidelines to ensure that services provided were both clinically appropriate and cost effective.
- Obtained authorizations from multiple insurance carriers for various levels of care.
- Performed prior authorization review of services requiring notification.
Education
Associate of Science - Education
University of Phoenix
Tempe, AZ12-2012
No Degree - Business Administration
Southwest Texas State University
San Marcos, TX05-1994
High School Diploma -
Sam Houston High
San Antonio, TX06-1991
Skills
- Insurance verification
- Customer service
- Data entry proficiency
- HIPAA compliance
- Team collaboration
- Attention to detail
- Problem-solving
- Multitasking and organization
- Verbal and written communication
- 10-key data entry
- Paperwork and documentation
- Customer service support
- Microsoft office
Timeline
Billing Specialist
3m
08.2015 - Current
Insurance Coordinator
WellMed Medical Management - United Health Group
10.2011 - 08.2014
Utilization Review Coordinator
UnitedHealthcare
09.2000 - 08.2011
Associate of Science - Education
University of Phoenix
No Degree - Business Administration
Southwest Texas State University
High School Diploma -
Sam Houston High
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