Summary
Overview
Work History
Education
Skills
Certification
Accomplishments
Websites
Education and Training
Timeline
BusinessDevelopmentManager
Tamara Holley

Tamara Holley

Field Reimbursement Manager
Chicago,IL

Summary

Results-driven Reimbursement Specialist with a strong background in reimbursement strategies and team leadership at Invivyd Pharmaceuticals. Notable achievements include streamlining processes that improved provider relations and enhanced patient account management. Expertise in medical billing, Medicaid, and policy evaluation, coupled with strong negotiation skills, ensures successful outcomes in complex healthcare environments. Dedicated to delivering exceptional client service while leveraging extensive industry knowledge.

Overview

10
10
years of professional experience
1
1
Certification

Work History

Field Reimbursement Manager

Invivyd Pharmaceuticals
Northeast Territory, IL
10.2024 - Current
  • Assisted in developing training materials for new staff members regarding reimbursement policies.
  • Determined medical necessity, using individual insurance carrier regulations.
  • Maintained accurate records of all reimbursements issued by the organization.
  • Created and implemented strategies to streamline the reimbursement process.
  • Educated physicians, staff, patients and stakeholders on service documentation for procedures and coding requirements.
  • Reviewed uninsured accounts, verifying medical assistance application process, charity care application and drug replacement program availability.
  • Coded patient care records to provide accurate information for billing.

Field Reimbursement Manager

HeartFlow
Mountain View, CA
01.2023 - 04.2024
  • Managed the Mountain-West territory.
  • Highlighted billing inconsistencies to optimize financial documentation processes.
  • Drafted documents based on payer guidelines and submitted to necessary parties.
  • Identified opportunities for coverage access to address reimbursement barriers.
  • Worked with billing department to reduce contract implementation errors.
  • Provided guidance to providers regarding the prior authorization process.
  • Monitored changes in insurance policies and guidelines to ensure compliance with prior authorization processes.

Field Reimbursement Manager

Argenex Bio-Pharmaceuticals (McKesson Contract)
Phoenix, , AZ
01.2022 - 04.2022
  • New Product Launch: VYVGART.
  • Coordinated communications among patients, providers, and payers concerning authorization status.
  • Maintained up-to-date knowledge of benefits trends and legislation with ongoing education.
  • Produced detailed guidelines outlining benefits frameworks.
  • Designed approaches to optimize coverage solutions for clients.
  • Monitored regulatory updates impacting healthcare benefits verification.

Field Reimbursement

Amgen (Syneos Health Contract)
Thousand Oaks, CA
07.2015 - 08.2017
  • Identified opportunities for coverage access to address reimbursement barriers.
  • Assisted in the development of new processes to ensure accurate claim submission.
  • Analyzed patient accounts to identify discrepancies in billing codes or charges.
  • Provided customer service support to clients inquiring about their reimbursement status.

Education

Bachelor of Science - Marketing

Northeastern Illinois University
12-1987

Skills

  • Reimbursement strategies
  • Team assistance and oversight
  • Medical billing
  • Medicaid expertise
  • Provider relations
  • Patient account reviews
  • Buy and Bill
  • Denial resolution
  • HCPCS coding
  • Medicare
  • Payer contracting
  • Chargemaster
  • Utilization review
  • Insurance verification
  • New product launch

HIPAA compliance

Revenue cycle management

Claims management

Effective customer communication

Reimbursement management

ICD-10 coding

Claims processing

Policy evaluation

Medicaid

Eligibility verification

Commercial insurance

Certification

  • Certified Contact Tracer 2020

Accomplishments

  • Rookie of the year (Akrimax Bio-Pharmaceutical 2013)
  • Territory Manager of the Year (Akrimak Bio-Pharmaceutical 2013)
  • Territory Manager of the Year (Akrimak Bio-Pharmaceutical 2014)

Education and Training

other

Timeline

Field Reimbursement Manager

Invivyd Pharmaceuticals
10.2024 - Current

Field Reimbursement Manager

HeartFlow
01.2023 - 04.2024

Field Reimbursement Manager

Argenex Bio-Pharmaceuticals (McKesson Contract)
01.2022 - 04.2022

Field Reimbursement

Amgen (Syneos Health Contract)
07.2015 - 08.2017

Bachelor of Science - Marketing

Northeastern Illinois University

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Tamara HolleyField Reimbursement Manager