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
Process implementation
Revenue Generation
Business development expertise
Planning and Coordination
Flexible and Adaptable
Accomplishments
- 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