Tameka Jowers
Hampton,VA
Summary
Bringing 15 years of experience in scheduling, patient relations, and electronic claims and referral processing, I offer a diligent and professional approach to my work. Throughout my career, I have developed a deep understanding of these areas and consistently delivered high-quality results. Eager to leverage my skills and expertise to make a valuable contribution to your company, I am confident that my strong work ethic and proven knowledge will enable me to excel in the role you have available.
Overview
14
14
years of professional experience
Work History
CLAIMS REPRESENTATIVE
United Healthcare
11.2022 - Current
- Worked productively in fast-moving work environment to process large volumes of claims.
- Maintained compliance with industry regulations by adhering to established procedures and guidelines in claims handling.
- Conducted detailed assessments of claims documents, ensuring accuracy and completeness before submission for approval.
- Achieved high levels of accuracy in claim assessment, minimizing company's exposure to risk.
- Maintained up-to-date knowledge of regulatory changes, ensuring company compliance and minimizing legal risks.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Checked documentation for accuracy and validity on updated systems.
REFERRAL COORDINATOR
Hampton Roads Community Health Center
03.2021 - 06.2022
- Retrieves and analyzes data from Electronic Health Records and Software, verbal/written instructions from Providers, and/or telephone messages regarding patient appointments, referrals, and pre-authorizations, Contacts applicable provider, specialist or medical facilities to schedule necessary appointments for patients, as requested by providers and/or transmit referrals electronically to providers, Provide key clinical information specified, including providing office visit notes, labs, procedure and test results as well as x-rays to receiving providers, Checks with Provider after referral appointments to verify patient kept appointment, as well as retrieving office notes for completed referral, Tracks the status of referrals by maintaining the Order Tracking Log, Records the expected time for return receipt of specialist reports, Refers patients who have not kept their referral appointment past90 days back to the referring provider for review, Processes prior authorizations for referrals and for insured patients
FRONT OFFICE ASSISTANT
Maico Audiological Services
06.2019 - 09.2020
- Schedule and verify patient appointments, Coordinate physician schedules and maintain patient flow by communicating patient arrivals or delays, Utilize EMR software to manage patient medical records to reinforce and uphold in accordance to facility and HIPAA confidentiality regulations, Collect co-payments and record transactions including end of day reconciliation, Secure prior authorizations for services
MEDICAL RECEPTIONIST
Gastroenterology Associates
03.2016 - 06.2019
- Schedule and confirm diagnostic appointments, surgeries and medical consultations, Collect and record demographics, Receive and route all calls to appropriate department, Interview patients to complete intake and insurance forms, scanning results and testing correspondence, Collect co-pays, coinsurance and deductibles, Verify insurance eligibility, Obtain authorization from third party payer for prescribed treatments
HOMECARE CLERICAL ASSISTANT
Bon Secours Homecare
04.2015 - 08.2015
- Evaluate and key demographics in regard to rehabilitation therapy, Compile daily referrals for client therapy, Document therapist statistical data including work product hours, Resolve client complaints and complete follow-up calls, Format and key all post therapy chart notes and client refusal, Acting Clinical Homecare Manager in absence of current clinical supervisor
OFFICE ASSISTANT
Tidewater Physicians Multispeciality Group
06.2014 - 04.2015
- Confirm patient appointments, Perform insurance verifications for all scheduled appointments, Secure appointments for ancillary, outpatient and specialist services, Manage daily financial ledger and all transactions, Import all medical correspondence and results in patient electronic medical record in timely manner and with accordance of HIPAA confidentiality regulations
OFFICE ASSISTANT/UNIT SECRETARY
Riverside Health System
01.2011 - 05.2014
- Obtain patient demographics, Check in and check out of scheduled patients, Collect co-pays, Verify insurance eligibility and benefits for ancillary services through third party payer online database, Assist scheduling of surgical procedures
- Maintain unit payroll records, Prepare purchase orders utilizing internal inventory management software, Monitor cardiac screen and appraisals, Interpret atrial and ventricular rhythm
- Collect and record telemetry data, Identify dysrhythmias and perform preventative action
ACCOUNTS PAYABLE CLERK
Riverside Health System
08.2010 - 01.2011
- Reconcile processed invoices through internal system data, Batch and key invoices to meet processing and monthly accounting reports, Resolve PO discrepancies with departmental staff and vendors, Verify charges to cost centers by analyzing reports for accuracy, Process credit memos in timely manner, Complete follow-up calls to vendors
Education
Bachelor of Science (B.S.) - Biology
ELIZABETH CITY STATE UNIVERSITY
Elizabeth City, NCSkills
- Microsoft office
- Insurance claims review
- Claims investigation
- Time management
- Data analysis
- Documentation review
- Claims processing
- Attention to detail
- Critical thinking
- Teamwork and collaboration
- Denied claims identification
- Organizing and prioritizing work
- Data entry software
- Data entry
- Proficient in software-Facets, Macess, Citrix, AthenaHealth and Epic
- 10-key touch
- Medical terminology
- Claim amount calculations
- Great mathematical skills
- Regulatory compliance adherence
- Multitasking Abilities
- Problem-solving abilities
- Excellent communication
- Organizational skills
- Computer proficiency
Timeline
CLAIMS REPRESENTATIVE
United Healthcare
11.2022 - Current
REFERRAL COORDINATOR
Hampton Roads Community Health Center
03.2021 - 06.2022
FRONT OFFICE ASSISTANT
Maico Audiological Services
06.2019 - 09.2020
MEDICAL RECEPTIONIST
Gastroenterology Associates
03.2016 - 06.2019
HOMECARE CLERICAL ASSISTANT
Bon Secours Homecare
04.2015 - 08.2015
OFFICE ASSISTANT
Tidewater Physicians Multispeciality Group
06.2014 - 04.2015
OFFICE ASSISTANT/UNIT SECRETARY
Riverside Health System
01.2011 - 05.2014
ACCOUNTS PAYABLE CLERK
Riverside Health System
08.2010 - 01.2011
Bachelor of Science (B.S.) - Biology
ELIZABETH CITY STATE UNIVERSITY
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