Myrea Tatum
Locust Grove,VA
Summary
Results-driven professional with background in authorization coordination, known for high standards and commitment to excellence. Expertise in managing authorization processes and improving operational workflows. Recognized for strong collaborative skills and adaptability, ensuring seamless team dynamics and goal achievement.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Pre-Certification Authorization Coordinator
UVA MEDICAL CENTER
02.2022 - Current
- Collaborated with multidisciplinary teams to ensure timely submission of documentation required for insurance approval.
- Improved patient care by efficiently coordinating authorizations for medical procedures and treatment plans.
- Facilitated timely renewals of ongoing authorizations by closely monitoring expiration dates and initiating renewal processes proactively.
- Enhanced communication between healthcare providers and insurance companies, reducing delays in patient treatment approvals.
- Reviewed authorizations from payer to determine approved or denied items.
- Calculated estimated copay based on current insurance benefits.
- Optimized workflows within the department by identifying areas of improvement and proposing actionable solutions.
- Developed comprehensive training materials for new Authorization Coordinators, contributing to their successful onboarding process.
- Decreased processing time for authorizations by establishing strong relationships with insurance representatives and case managers.
- Stayed informed about regulatory changes relevant to the healthcare industry, ensuring compliance in all authorization activities.
- Acted as a resource for clinical staff, providing guidance on insurance requirements and authorization protocols.
Prior Authorization Specialist/Patient account representative
Mary Washington Home Health and Hospice
04.2019 - 01.2022
- Responsible for obtaining timely insurance authorization and verification for patients who require services from Mary Washington Home Health
- Verifies patient eligibility, insurance coverage information and ensures authorization requirements have been met
- Obtains initial and subsequent authorization for all non-Medicare payers before services are rendered including over visit limits
- For self-pay and/or charity patients, verifies eligibility for all Medicaid products
- Assists Intake Specialists, Clinicians and billing department with communicating patient/guarantor financially responsibility when clarification is needed, or variance occurs
- Audits patient admissions
- Monitors appropriate reports related to insurance verification and authorization processes to ensure timely notification and insurance verification processing
- Responsible for follow-up and monitoring compliance with CMS guidelines regarding face-to-face documentation
- Monitors and initiates sending face-to-face documents to the certifying physician for signature
- Monitors return and appropriateness of returned documentation
- Monitors payor communications/updates
- Demonstrates a thorough knowledge of insurance guidelines including Medicare and Medicaid regulations related to HPS/CGS
- Provides feedback to all appropriate Managers on appropriate payer issues and trends
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
Senior Medical Office Assistant
UVA Novant OB/GYN
10.2016 - 08.2018
- Schedules and registers patients, takes payments and provides receipts
- Answers telephones, screens calls, confirms appointments, maintains appointment schedule following office scheduling procedures
- Refers callers to appropriate individuals, and gives routine information in accordance with established procedures
- Posts clinic collected payments in online journal, verify collections against monies on hand, document discrepancies as needed according to cash collection policy
- Assists patients with forms, which includes making sure all necessary information is provided, and contact appropriate parties as necessary
- Obtains insurance authorizations and referrals as needed
- Checks in patients upon their arrival and verifies patient information; updates patient tracking, provides patient with medication list, assures accuracy and completeness of co-pays, charges and insurance information
- Manage Referral Work que/Referral coordinator in Epic and keep up to date -Provides routine information in accordance with established procedures
Lead Medical Administrative Assistant/Medical Assistant
MedExpress Urgent Care
07.2014 - 10.2016
- Responsibilities
- Filling Out Insurance Forms
- Filing Patient Medical Records
- Maintaining the Confidentiality of Patient Information
- Managing inventory and ordering supplies
- Scheduling Patient Medical Procedures
- Following Up On Patient Visits
- Updating Patient Charts
- Ordering Lab Tests
- Billing Patients
- Working with Insurance Companies
- Managing Petty Cash
- Skills Used
- Taking Patient Vital Signs
- Taking Medical Histories
- Preparing Patients for Medical Tests and Examinations
- Assisting Physicians During Examinations
- Explaining Medical Procedures to Patients
- Sterilizing Medical Instruments
Education
Associate's - Science
Miami-Dade Community College
Miami, FL01.2013
Skills
- Prior authorization
- Multitasking and organization
- Insurance billing
- Medical terminology
- HIPAA regulations
- Medical office management
- EMR / EHR
- Data entry efficiency
- Billing procedures
- Utilization review experience
Certification
- CPR Certification
- Certified Medical Administrative Assistant, 06/01/13
- Certified CPR, 02/01/12
- Certified MDHBA-CPAS, 03/01/16
Personal Information
- Authorized To Work: US for any employer
Languages
English
Native or Bilingual
Timeline
Pre-Certification Authorization Coordinator
UVA MEDICAL CENTER
02.2022 - Current
Prior Authorization Specialist/Patient account representative
Mary Washington Home Health and Hospice
04.2019 - 01.2022
Senior Medical Office Assistant
UVA Novant OB/GYN
10.2016 - 08.2018
Lead Medical Administrative Assistant/Medical Assistant
MedExpress Urgent Care
07.2014 - 10.2016
- CPR Certification
- Certified Medical Administrative Assistant, 06/01/13
- Certified CPR, 02/01/12
- Certified MDHBA-CPAS, 03/01/16
Associate's - Science
Miami-Dade Community College
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