Tamala Wise

Results-driven Payment Resolution Specialist II at Trinity Health, adept at enhancing revenue through meticulous billing audits and effective conflict resolution. Demonstrated strong problem-solving skills by recovering substantial denied claims and improving cash flow. Known for attention to detail and effective communication, ensuring a seamless patient intake experience. Experienced with resolving complex disputes and managing client relations. Utilizes conflict resolution techniques to address and solve issues efficiently. Track record of effective communication and problem-solving that enhances team performance and client satisfaction. Professional with robust background in conflict resolution and customer service. Skilled in navigating complex issues, implementing solutions, and ensuring client satisfaction. Strong collaborator with focus on team synergy and adaptability to changing demands. Proven ability to communicate effectively, mediate disputes, and achieve results-driven outcomes. Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level Billing and Follow Up position. Ready to help team achieve company goals. Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions. Identifies and escalates issues affecting . Prepare special reports as directed by the Supervisor Billing and Follow-Up to document follow-up services, e.g., number of claims and dollars billed, claims edited, claims unprocessed,accurate billing and follow-up activities. Assists in the training and education of Billing and Follow-up Representative I colleagues upon hire and ongoing, and as new systems, processes or payers are created.. Provides problem resolution to billing and follow-up issues as needed. Other duties as needed and assigned by the supervisor. Adheres to proactive practices which includes contacting the payer directly for payment due on accounts and reviewing and responding to all mail correspondence in a timely and accurate manner.

• Achieved and OVERTURNED Appeals by completing Provider Disputes with accuracy and efficiency.
• Collaborated with team in the development of the Technical denials team.
• Achieved denied claims by completing Provider Disputes and Appeals with accuracy and efficiency.
• Achieved effective Payment Resolution through helping with no authorization and Technical denials.
• Documented and resolved technical denials which led to success in OVERTURNING denied medical claims.

• MEDICAL ASSISTANT Certificate of completion