Ta'Kisha Murphy

Work History

Global Account Executive

GeoBlue Worldwide Insurance Services

10.2023 - Current

Project Management of Global Customer Service Projects
Provided exceptional customer service through timely communication, issue resolution, and relationship-building efforts.
Secured long-term contracts, consistently exceeding quarterly revenue goals.
Define, build, and implement project management capabilities.
Continuous improvement mindset.
Overseas liaison for Federal Employee Program Members to provide healthcare benefits with preferred providers while residing or travel aboard.
Build and maintain customer service KPI tools for high-volume of 45 to 95 calls per Member reporting across regions.
Addressing assigned cases to medical management and facilitate issuing of healthcare benefits for FEP members aboard.

Contract Definition Analyst (Short Term Contract)

Swoon Group

04.2023 - 07.2023

Enhanced contract compliance by meticulously reviewing and analyzing contractual documents.
Streamlined negotiation processes for faster contract approvals, implementing efficient tracking systems.
Reduced risk by identifying potential contractual issues and effectively addressing them with stakeholders.
Increased cost savings for company by skillfully negotiating favorable contract terms and conditions.
Improved contract management efficiency through implementation of centralized database system for easy access to all relevant documentation.
Facilitated cross-functional collaboration for successful 49 contract executions, fostering strong relationships between departments.
Developed customized templates for various types of contracts, expediting drafting process and reducing errors.
Maintained high level of industry knowledge by staying updated on current trends and regulatory changes affecting 32 contracts.
Provided training to team members on best practices in contract management, enhancing overall departmental proficiency.
Managed multiple contract portfolios concurrently, ensuring adherence to deadlines and organizational goals.
Played integral role in dispute resolution by facilitating mediation efforts between parties involved in contractual disagreements.

AR Specialist II

Amsurg, Envision Healthcare Inc

02.2022 - 03.2023

Excellent communication skills and strong customer service skills.
Followed all company policies and procedures to deliver quality work.
Interpreted clients' needs and introduced services to fit specific requirements.
Evaluated diverse organizational systems to identify workflow, communication, and resource utilization issues.
Extensive working knowledge of managed care networks and insurance carriers.
Extensive working knowledge of accounts receivable functions, including CPT and ICD-10 coding.
Working in Vision, NextGen, and Advantix systems.
Contacted clients with past-due accounts to formulate payment plans and discuss restructuring options.
Identified, researched, and resolved billing variances to maintain system accuracy and currency.
Reviewed accounts on monthly basis to assess aging and pursue collection of funds.
Managed monthly reconciliation schedules for assigned accounts.
Listened and responded to customer requests and forwarded necessary information to superiors.

Contract Management Specialist

Medhost

11.2020 - 01.2022

Maintaining reimbursement rules and supporting data tables for use in hospital contract management software through research and defining methods of revenue recovery.
Developing methods (logic) for accurately valuing inpatient & outpatient claims with a focus on revenue recovery.
Developed and followed processes to manage 17 contracts and remain in compliance with company commitments and regulatory obligations using Salesforce.
Verified submitted documents for completeness and compliance with company policies, addressing discrepancies and collaborating to troubleshoot where necessary.
Collected, organized, and modeled data using Salesforce.
Helped leaders understand how to effectively manage.
Answering over 45 pre-evaluation-related support tickets from clients.
Analytical skills, Focus, Accuracy, and Timelines are paramount qualities.
Research and define evaluation logic primarily for Medicare hospital claims valuation, with commercial payer websites for adjudication rules.
Downland provider manuals, reimbursement policies, and medical policies for use in hospital and applicable commercial payer valuations.
Provide internal consulting for enhancement of Hospital Claims Scrubbing application.
Conducted research and investigations into Covid-19 related diagnoses.
Evaluated diverse organizational systems to identify workflow, communication, and resource utilization issues.
Gathered, documented, and modeled data to assess business trends.
Developed and followed processes to manage contracts and remain in compliance with company commitments and regulatory obligations.
Worked collaboratively with administrative staff in negotiation, correspondence, documentation, and compliance checks for service contracts
Conducted thorough reviews of operations to devise and deploy improvement strategies.

Account Specialist

Convergent USA

02.2019 - 08.2020

Think critically through implementation of plans to identify gaps and make necessary changes and adjustments.
45 daily accounts worked to resolution in efforts to recover facility unresolved balances surrounding all denial types from all payers
Investigated and resolve claim variances.
Resolves client and audit issues to completion with attention to detail and high levels of professionalism.
Completed in-depth research to investigate claims and resolve problems.
Assessed individual situations and developed effective and appropriate resolutions.
Monitored aging accounts and reached out to customers to discuss payments.
Rounding each area of service center to learn processes (Billing AR follow-up, Denials, Cash Posting) to assist with determining process improvement.

Insurance Collector III

Navient Solutions

08.2018 - 01.2019

Resolved 30 to 45 Claim denials review and corrections per day.
Requesting Retro authorizations for services rendered requiring authorization.
Appeals for not medically necessary, not classified, or experimental procedures.
Claim review for coding denial for diagnosis, modifier use, and inappropriate procedure code due to payer-specific guidelines.
Contract coherence per contract review per capitation health versus medical plans for correct billing based on levels of responsibility surrounding yearly Dophers.
Entered client details and notes into system for interdepartmental access and review.
Processed debtor payments and updated accounts to reflect new balances.
Worked with customers to create debt repayment plans based on current financial conditions.
Worked with customer to create debt repayment plan based on current financial conditions.
Listened to customers and negotiated solutions that met creditor and debtor needs.

Account Reimbursement Specialist II

Vanderbilt Medical Center

04.2014 - 12.2018

Specializing in Coding, Retro-Authorizations, Appeal Denials, Project Management, and Credit Balance Analysis & Resolution.
Provides feedback to physicians and providers based on documentation reviewed.
Offers suggestions for improvements based on coding/billing requirements and coding policies (CMS VS AMA).
Demonstrates knowledge to work coding denials, received from third-party payers including MCO, Medicaid, & Medicare.
High-Volume of over 50 calls per day
Third-party billing, claim to correct, addressing daily correspondence directly related to workers' compensations and auto accidents inquiries, billing, and lawsuits for reimbursement and collection efforts.
Followed up on denied and unpaid claims to resolve problems and obtain payments.
Guided office staff on how to effectively complete prior authorization forms and appeals documentation to achieve positive results.
Increased revenue by identifying and resolving billing errors in timely manner.
Streamlined revenue cycle process for improved efficiency and faster payment collection.
Ensured accurate billing with thorough audits of patient accounts and insurance claims.
Reduced outstanding account balances by implementing effective collection strategies.
Collaborated with cross-functional teams to improve overall financial performance of organization.
Analyzed financial reports to identify trends and areas for improvement in revenue cycle operations.
Developed and implemented policies and procedures to maintain compliance with industry regulations and standards.
Trained new team members on revenue cycle best practices, contributing to more knowledgeable workforce.
Maximized reimbursements by staying current on payer requirements and maintaining strong relationships with insurance providers.
Improved cash flow with diligent follow-up on pending claims and appeals processes.
Managed portfolio of high-risk accounts, effectively reducing bad debt write-offs through proactive communication and negotiation tactics.
Coordinated patient payment plans, balancing compassion with firmness to ensure timely payments while preserving positive patient relationships.
Achieved optimal reimbursement rates by verifying insurance coverage, eligibility, benefits, and authorization prior to service delivery.
Provided regular updates on billing status to upper management through detailed reports.
Implemented software solutions for better tracking of key performance indicators within revenue cycle process.
Assisted patients in understanding complex billing statements, leading to increased trust between patients and healthcare providers.
Served as liaison between clinical departments, finance, and administration, ensuring smooth communication for proper revenue cycle management.
Identified and resolved payment issues between patients and providers.
Contacted responsible parties for past due debts.
Reached out to insurance companies to verify coverage.
Balanced and reconciled accounts.

Summary

Overview

Work History

Global Account Executive

Contract Definition Analyst (Short Term Contract)

AR Specialist II

Contract Management Specialist

Account Specialist

Insurance Collector III

Account Reimbursement Specialist II

Education

Certificate of Management - Business Management

Associate of Applied Science - Medical Billing & Coding

General Studies - Political Science

Skills

Work Availability

Timeline

Key Qualifications

Key Qualifications

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