Tamara Cooper

Processed and submitted claims to various insurance providers, ensuring compliance with industry regulations.

• Researched denied claims thoroughly, collaborating with insurance representatives to expedite resolutions effectively.
• Conducted regular audits of billing records to maintain accuracy and compliance with healthcare standards.
• Coordinated with medical professionals to verify patient information and authorizations prior to billing.
• Managed complex patient inquiries regarding account statements, fostering positive relationships through effective communication.
• Researched and resolved billing discrepancies to enable accurate billing.
• Identified, researched, and resolved billing variances to maintain system accuracy and currency.
• Worked with multiple departments to check proper billing information.
• Assisted colleagues in resolving complex billing issues, promoting teamwork and knowledge sharing within the department.
• Reduced errors in financial records by conducting regular audits of billed accounts.
• Contributed to improved financial reporting by reconciling discrepancies between invoiced amounts and actual payments received.
• Ensured compliance with industry regulations by staying up-to-date on changes in billing rules and guidelines.
• Improved customer satisfaction with prompt and clear communication regarding their billing inquiries.
• Fostered strong relationships with healthcare providers and insurance representatives to facilitate efficient resolution of billing issues.
• Contributed to positive work environment by offering support and guidance to junior billing staff.
• Reduced billing errors, leading to decrease in customer complaints, by conducting regular audits of billing data.
• Negotiated with insurance companies to resolve disputed claims, securing rightful payments.

• Prepared and coded claims to be submitted to Insurances. Critical thinking and problem-solving skills. Analyze medical records and determine the correct codes for each diagnosis and procedure. This could prove challenging as multiple codes could be applicable to a single medical record. Applied Insurance payments when needed. Refunded to patient or Insurance when required. Follow up on Insurance claims by calling/emailing/chatting with Insurance reps. Follow up with resubmissions to Insurances to get claims paid/adjusted. Worked closely with Rehab Case Managers to ensure PWC orders went as smoothly as possible. Followed up with Case Managers to extend authorizations, update Insurance info, etc.
• **Monitored claim submission timelines, ensuring adherence to payer requirements for timely processing.**
• Collaborated with the collections team to recover overdue payments from clients, maintaining cash flow and minimizing writeoffs.
• **Tracked authorization requests and follow-ups, minimizing delays in patient service delivery and revenue collection.**
• Enhanced customer satisfaction with timely and accurate invoice generation.
• Maximized revenue potential by identifying and resolving under-billed accounts.
• Maintained up-to-date knowledge of billing regulations and compliance requirements, ensuring adherence to legal standards.

• Assisted customer with billing payments and concerns. Collects and posts payments to customer accounts. Records pertinent data on collection efforts and customer financial status in database. Attempted to work payment plans with customers. prepared packets for collections and sent to an outside collection agency. Performs administrative and clerical functions as needed such as recording address changes and purging inactive records. Performs other related duties as assigned.

• Completed disability intake forms for new clients
• Answered phone calls and helped clients with questions
• Called the clients and assisted them with their evaluation for qualifying for disability
• Had the highest rate of reaching my weekly goals
• Called clients to update them on their claims
• Collected additional medical clients to ensure their applications were completed
• Mailed paper retainers to clients for their signatures
• Completed tasks assigned to me in a timely manner
• **Maintained detailed records of client interactions and case progress, ensuring compliance with documentation standards.**
• Answered phone calls and provided new clients with required paperwork to initiate service.
• Increased customer satisfaction with timely follow-ups, ensuring all necessary documentation was collected and processed promptly.
• Completed intake assessment forms and filed clients' charts.
• Maintained high levels of accuracy and compliance in data entry, ensuring all information was correctly entered into the required systems.
• Utilized critical thinking skills to analyze complex client situations and make informed recommendations for appropriate services and support.
• Provided compassionate support to clients during the intake process, offering reassurance and understanding in times of distress.
• Ensured client confidentiality by adhering to strict privacy policies when handling sensitive information during the intake process.
• Collected, verified, recorded and processed client demographics, insurance payments, and referral information.

• Managed team members to ensure they were on task and assisting the clients while following HIPPA regulations on a daily basis
• Processed new account applications and determined if a member was eligible for membership
• Reviewed and graded phone calls for team of licensed benefit advisors to ensure quality and regulations were met
• Handled grievances with customers/clients
• Sent monthly reports to my supervisor that were assigned directly to me
• Ensured training and weekly meetings were completed by team
• Led cross-functional teams in troubleshooting issues, enhancing collaboration among various departments for seamless operations.
• Managed quality control processes, reviewing work outputs to maintain high standards and client satisfaction.
• Executed training programs for new staff, promoting skill development and adherence to company policies.
• Analyzed project performance data to identify areas for improvement, driving continuous enhancements in service delivery.
• Oversaw compliance audits, reinforcing best practices to mitigate workplace hazards.
• Worked with personnel and managers to meet strict timelines.
• Developed work schedules for team members to maximize shift coverage.
• Implemented best practices and safe operating procedures.

• Successfully led key projects which resulted in a more positive experience for customers and service team.
• Navigated through the companies systems successfully
• Successfully led key projects which resulted in training to ensure adequacy
• Provided onsite training
• Monitored multiple inventory and stock to keep track of all company inventory as well as maintaining adequate inventory for a smooth flowing restaurant
• Organized and managed banquets for large groups and organizations
• Coached members of my team
• Managed scheduling to ensure employees had proper coverage
• **Conducted regular training sessions to elevate staff performance and ensure adherence to service standards.**
• **Maintained compliance with health and safety regulations, fostering a safe dining environment for patrons.**
• **Monitored customer feedback closely to identify areas for improvement and enhance guest satisfaction levels.**
• Managed daily operations to ensure a high level of efficiency, consistency, and quality in both food and service.
• Carefully interviewed, selected, trained, and supervised staff.
• Met, greeted, and encouraged feedback from customers and used feedback to implement positive changes within restaurant.
• Correctly calculated inventory and ordered appropriate supplies.
• Promoted positive atmosphere and went above and beyond to guarantee each customer received exceptional food and service.
• Monitored inventory of supplies and purchased orders to maintain adequate stock levels.
• Promoted a positive work environment with proactive conflict resolution strategies and team-building activities.
• Conducted performance evaluations for staff members, identifying areas of improvement while recognizing outstanding achievements as well.
• Enhanced guest experience by regularly reviewing feedback and implementing necessary improvements.
• Quickly identified problem situations and skillfully resolved incidents to satisfaction of involved parties.
• Ensured compliance with local health department regulations through regular staff training sessions and facility inspections.
• Oversaw inventory management processes to minimize waste and maintain optimal stock levels for seamless operation.
• Conducted health, safety, and sanitation process evaluations to identify and remedy any violations immediately.