NextGen
Syreeta Ray
Supervisor Of Authorizations And Funding
Fredericksburg,VA
Summary
Dedicated health care professional with twenty-three year history of meeting company goals utilizing consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand. I am organized and dependable with success at managing multiple priorities with a positive attitude. I pride myself on my willingness to take on added responsibilities to meet team goals.
Overview
23
23
years of professional experience
7
7
years of post-secondary education
Work History
Authorization and Funding Supervisor
Colorado Retina Associates
Denver, CO
05.2022 - Current
- Performed procedural analysis and develop partnerships to strategize how to correct deficiencies, refine policies for improvement and execute plans.
- Mentor and coach staff.
- Support Revenue Cycle Director with special projects and additional job duties.
- Established coding procedures, monitored reports and updated internal files for Prior Authorization and Funding objectives, supporting high level approval results.
- Recruited, interviewed and hired two employees and participated in mentoring program to promote positive feedback and engagement.
- Perform routine audits of staff performance ensuring team metrics are met.
Authorization and Funding Lead
Colorado Retina Associates
Denver, CO
01.2021 - 05.2022
- Oversee staff responsible for obtaining prior authorization for all in-office procedures as well as identifying patient copay assistance programs.
- Issued instructions and assigned duties to Authorization and Funding staff.
- Assist Supervisor with time management of staff.
- Provided training and on-going education of staff.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Processed patients lacking coverage for planned procedures.
- Collaborated with Clinical Assistants by creating and maintaining spreadsheets detailing medical procedures and insurance denials and approvals.
- Maintained close relationship with Clinical, Front Desk and Billing staff.
Authorization and Funding Coordinator
Colorado Retina Associates
Denver, CO
01.2018 - 01.2021
- Verified eligibility and compliance with authorization requirements for service providers.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Reached out to insurance carriers to obtain prior authorization for all in-office procedures.
- Created and maintained spreadsheets detailing medical procedures and insurance denials and approvals.
- Triaged unscheduled and emergency authorizations, directing submissions to appropriate personnel for rapid response.
- Tracked referral submission during facilitation of prior authorization issuance.
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
Vice President of Operations
Developmental Horizons
Las Vegas, NV
09.2016 - 01.2018
- Successfully integrated three Behavioral Healthcare Centers into one collaborative healthcare system providing wrap-around services to clients.
- Supported Executive Team in reviewing, identifying and prioritizing initiatives.
- Built and strengthened relationships across functional leadership areas to keep revenue development and operational plans interconnected and effective.
- Strategically coordinated operations according to objectives and capabilities, effectively allocating resources to meet demands.
- Oversaw hiring, adding valuable, talented professionals to strengthen case management team.
- Attended trade shows and client meetings, promoting brand and building rapport with prospects.
- Set clear goals to monitor targets and offered real-time input on performance and motivation.
Medical Billing and Collections Specialist
Colorado Retina Associates
Denver, CO
06.2012 - 09.2016
- Verified eligibility and compliance with authorization requirements for service providers.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Reviewed patient records, identified medical codes and created insurance claims and invoices for billing purposes.
- Posted payments and collections on regular basis.
- Processed billing calls and answered questions from patients and third-party carriers.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Assisted in reconciling deposit and patient collections.
- Adhered to established standards to safeguard patients' health information.
Senior Claims Examiner; Pension Clerk
Southwest Administrators
Las Vegas, NV
02.2000 - 06.2012
- Managed large volume of medical and dental claims on daily basis.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
- Reviewed provider coding information to report services and verify correctness.
- Used administrative guidelines as resource or to answer questions when processing medical claims.
- Paid or denied medical and dental claims based upon established claims processing criteria.
- Performed multifactor data and cost analyses for use in areas such as support of collective bargaining agreements.
- Delivered targeted advise on issues such as applicable employment regulations and compensation strategies.
- Executed record filing system to improve document organization and management.
Education
Bachelor of Science - Health Administration
University of Phoenix
Tempe, AZ 09.2016 - 12.2019
Associate of Applied Science - Business Administration And Management
Everest College - Henderson
Henderson, NV 05.2005 - 11.2008
Skills
Relationship building and management
undefinedAccomplishments
- Achieved exceptional time management by introducing SamaCare and PX Technology for Authorization and Funding tasks.
- Collaborated with team of five in the development of LEAN protocols for detailing authorization communication.
- Used Microsoft Excel to develop high cost drug samples tracking spreadsheets.
Software
MDI
Microsoft Office Suite
Timeline
Authorization and Funding Supervisor
Colorado Retina Associates
05.2022 - Current
Authorization and Funding Lead
Colorado Retina Associates
01.2021 - 05.2022
Authorization and Funding Coordinator
Colorado Retina Associates
01.2018 - 01.2021
Vice President of Operations
Developmental Horizons
09.2016 - 01.2018
Bachelor of Science - Health Administration
University of Phoenix
09.2016 - 12.2019
Medical Billing and Collections Specialist
Colorado Retina Associates
06.2012 - 09.2016
Associate of Applied Science - Business Administration And Management
Everest College - Henderson
05.2005 - 11.2008
Senior Claims Examiner; Pension Clerk
Southwest Administrators
02.2000 - 06.2012
Similar Profiles
Omari DickersonOmari Dickerson
SUPPORT SERVICES MANAGER at Colorado Retina AssociatesSUPPORT SERVICES MANAGER at Colorado Retina Associates
Evelyn VickersEvelyn Vickers
Frest Desk Coordinator at Colorado Retina AssociatesFrest Desk Coordinator at Colorado Retina Associates
Kailyn EmoryKailyn Emory
Registered Nurse at Children's Hospital ColoradoRegistered Nurse at Children's Hospital Colorado