Summary
Overview
Work History
Education
Skills
Timeline
Generic

Tamika Davis

Charlotte,NC

Summary

Highly experienced professional dedicated to providing excellent assistance to Physicians and patients. Exceptional interpersonal skills, handles physician and patient interactions with tact and diplomacy. Thrives in a fast pace environment and able to manage and prioritize different job duties with ease.

Overview

26
26
years of professional experience

Work History

Patient Services Coordinator

OrthoCarolina
  • Answer incoming calls from providers, patients and nurses
  • Assure patients are scheduled with proper problem team
  • Schedule appointment based on each physician preferences
  • Handled the rescheduling of 12 physician’s appointments when they sign out for emergencies
  • Navigate 4 Information Systems while viewing patient’s electronic medical record
  • Provided directions to patients while in route to their appointment
  • Analyzed and interpreted patients notes to assist with triage
  • Utilized great customer service and data entry skills to document patient demographic information.

Physician Referral Coordinator

OrthoCarolina
  • Served as a liaison between referring Physicians, patients and nurses by answering all incoming calls
  • Handled all incoming referrals via phone call, online referral portal or fax
  • Handled the rescheduling of all Spine Center physician’s appointments when they sign out for emergencies
  • Responsible for Spine Center physicians schedule to assure that they are signed out of clinic
  • Assist Practice Manager with Patient Impact survey call backs
  • Assist the physicians, administrative assistants, and nurses with special scheduling needs
  • Responsible for all Spine Center Appointment Request Tasking
  • Analyzed and interpreted patients notes to assist with triage
  • Utilized great customer service and data entry skills to document patient demographic information.

Appointment Scheduler

OrthoCarolina
  • Answer incoming calls from providers, patients and nurses
  • Assure patients are scheduled with proper problem team
  • Call Center trainer for new employees
  • Handled the rescheduling of 14 physician’s appointments when they sign out for emergencies
  • Navigate 2 Information Systems while viewing patients’ information
  • Utilized great customer service and data entry skills to document patient demographic information.

Proof Operator

Branch Banking & Trust
01.1999
  • Enhanced proof machine was set properly foe encoding
  • Developed an understanding of the research and adjustment process.

Talent Acquisition Specialist

Randstad
10.2022 - 08.2024


  • Building a candidate database using proactive sourcing
  • Source and screen candidates to make the match for our clients
  • Work with account managers
  • Conduct phone and video interviews
  • Maintain all KPI standards
  • Maintained the required fill rates
  • Close and sell candidates on the positions that are the best fit for them
  • Managed full-cycle recruiting process for multiple roles simultaneously while maintaining high-quality standards in candidate assessment and selection.
  • Evaluated resumes, interviewed, and presented qualified candidates to hiring managers and solicited feedback to refine recruiting strategy.
  • Acted as brand ambassador to educate candidates on culture, career growth, benefits, and advantages of working for company.
  • Established strong relationships with key stakeholders, ensuring clear communication and alignment on talent acquisition goals and objectives.
  • Improved interview processes through the development and implementation of structured interview guides tailored to each role''s unique requirements.
  • Leveraged social media platforms to advertise open positions, reaching wider audience and increasing application rates.
  • Assisted with writing job postings and job descriptions for boards.

Insurance Verification & Billing Specialist

Novant Health Hospice Services
11.2020 - 10.2022
  • Research and verify insurance coverage on all incoming referrals and accurately interpret patient benefits to assure Hospice coverage
  • Has advanced knowledge and understanding of Commercial and Government payors with evidence of recouping millions of dollars
  • Has full understanding of Coordination of Benefits, Authorization guidelines, Medical Benefit variances, as well as Medical Necessity Policies
  • Validate insurance eligibility and benefits via phone and or payer’s websites
  • Review practice and insurance company guidelines to ensure prior approval requirements are met
  • Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes
  • Utilize EHR to provide appropriate documentation necessary for determination
  • Update patient’s status in Epic and Medicare’s Direct Data Entry system (DDE)
  • Have a strong familiarity with government and commercial payers including Medicare and Medicaid
  • Medicare Billing experience and working knowledge of ICD-10 and CPT codes
  • Monitor and work 15 plus work ques daily
  • Complete claim edits and resubmissions within timely filling guidelines
  • Understand the Joint Commission Accreditation
  • Handled Payor Audits
  • Was successful in resolving complex billing issues and leading Special assignments
  • Collaborate with insurance payers and Provider Relations Teams to determine why claims have been denied and what information is needed to resubmit claim successfully
  • Work with other departments and associates to resolve issues and assist in implementing improvement
  • Ensure all account activity is documented in Epic timely and thoroughly
  • Document Death Certificates being received daily and prepare them to be signed by the Physician
  • Answer all incoming calls to the Hospice Nurse Case Manager Triage line and send messages to the assigned case managers
  • Scan urgent medical records to the patients chart
  • Understanding of HIPAA guidelines/regulations
  • Knowledgeable and have a thorough understanding of Commercial and Government payors with regards to Coordination of Benefits, Authorization guidelines, Pharmacy and Medical Benefit variances, as well as Medical Necessity Policies.

Referral Specialist

Charlotte Eye, Ears, Nose & Throat Associates
10.2018 - 11.2020
  • Receive income referrals from different Medical Offices
  • Contact patients and schedule based on the referral receive by their PCP
  • Answer all incoming calls to the Provider Services Line for urgent appointments, Provider to Provider calls and Hospital consultation requests
  • Scan incoming referral using the EMR system
  • Scan urgent medical records to the patients chart.

Care Coordinator / Surgery Scheduling Specialist

Atrium Health Care
07.2017 - 10.2018
  • Work closely with Gastroenterology RN to facilitate exceptional medical care to patients
  • Counsel and educate patients in preparation for multiple Gastroenterology procedures
  • Triage patients for medical issues and concerns
  • Coordinate Gastroenterology physicians at 7 medical locations within the Charlotte & Huntersville areas
  • Responsible for ensuring that insurance precertification is obtained
  • Scheduled Gastroenterology procedures for 7 physicians at multiple local surgery centers and hospitals
  • Managed physician personal schedule.

Precertification & Referral Manager

Westmed Practice Partners
11.2015 - 01.2017
  • Verified all insurance benefits for Infertility and Infusion patient for multiple physicians and specialties
  • Assure that each procedure is coded properly with the correct ICD10 or CPT code for obtaining authorizations
  • Properly documented patient accounts using information obtained from various insurance Companies
  • Calculated estimated patient cost share based deductible and out of pocket amounts obtained from insurance carriers
  • Achieved and maintain verification productivity
  • Conducted daily investigations to validate the insurance eligibility of patients scheduled for upcoming specialty appointments that require a referral
  • Try to maintain a QA score of 96% or better
  • Obtain referral and/ or precertification for patients for internal and external appointments or orders
  • Communicating information pertaining to referrals and/ or precertification to patients, external medical offices and internal staff
  • Handled any escalated issues related to verifying insurance benefits and obtaining precertification Authorizations
  • Completing assigned special projects as needed these can include but are not limited to research projects pertaining to insurance company benefit guidelines and requirements.

Managed Care Coordinator / Surgery Scheduling Specialist

Carolina Neurosurgery & Spine
04.2015 - 11.2015
  • Work closely with Spine Surgeons RN to facilitate exceptional medical care to patients
  • Placed calls to various health plans to obtain appropriate precertification prior to the patient’s appointment
  • Worked closely with the physician’s administrative assistant to advise if the precertification is approved, denied or required a peer-to-peer review
  • Coordinate physicians at 7 medical locations within the Charlotte & Huntersville areas
  • Responsible for ensuring that insurance precertification is obtained and entered into NextGen and routed to the appropriate staff.

Pre Registration & Benefits Verification Supervisor

Community Health Systems
07.2013 - 01.2015
  • Verified all insurance benefits for inpatient, outpatient, surgical procedures, scheduled Radiology procedures and other high dollar procedures to determine if insurance coverage meets the standards of admission for 12 hospitals
  • Assure that each procedure is coded properly with the correct ICD9, ICD10 or CPT code for billing and obtaining authorizations
  • Verified patient coverage for patient infusions to assure proper reimbursement
  • Properly documented patient accounts using 15 points of insurance verification
  • Calculated estimated patient cost share based on contract guidelines
  • Achieved and maintained verification productivity of 60-80 accounts per shift for BCBS & 35-60 for other payers
  • Achieved and maintained verification accuracy of 98% or greater
  • Contacted patients on call list to advice of their estimated responsibility before scheduled procedure
  • Managed 30 associates and the day-to-day operations of the Pre-Arrival Unit
  • Assisted in hiring and the yearly evaluation process
  • Handled any escalated issues related to verifying insurance benefits and obtaining precertification Authorizations.

Team Leader

OrthoCarolina
08.2006 - 01.2013
  • Led the Patient Services Specialist, Patient Services Coordinator and Urgent Care team
  • Managed the day-to-day operations of the front desk, Call Center and Orthopedic Staff
  • Supervised and Coordinates all clinic functions for Urgent Care which consists of 2 Patients Services Specialists, 2 clinical Assistants and 1 Radiology Technologist
  • Participated in the interviewing and selection process of all new staff for our day and Urgent Care staff
  • Developed, coordinated and maintained all the schedules for all PSS, PSC, clinical and radiology staff for day and Urgent Care clinic
  • Evaluated departmental activities to ensure staff relations, balanced workloads and efficiency of services
  • Led monthly staff meetings and morning huddles to insure good communication among each team
  • Assisted in the development, implementation, evaluation and enforcement of departmental and clinical policies and procedures
  • Collected and analyzed performance data by running daily audit reports and reviews
  • Assured that all staff was proficient in assigned job duties and re-trained the staff when appropriate
  • Scheduled all training and cross training where appropriate
  • Prepared monthly meeting materials, records and notes
  • Investigated and provided resolution of complaints and problems
  • Processed time and attendance to include PTO and attendance call outs
  • Insured the updating of patient demographic information
  • Accurately assured the correct posting of charges and copays
  • Built and fostered strong relationships with all physicians, patients and co-workers.

National Accounts Customer Service Representative II

Cigna Health Care
06.2004 - 01.2006
  • Answer a high volume of incoming calls from members and providers
  • Documented and worked accurately in a fast-paced call center with an average handle time of 314 seconds per call
  • Quote members and providers with eligibility, benefits and claim status
  • Navigate 17+ Information Systems while viewing claims to assure accurate processing by claims processors with correct coding
  • Demonstrated initiative to handle all issues in a timely fashion while still providing excellent customer Service
  • Accurately followed all Standard Operating Procedures.

Shipping & Receiving Clerk

Distribution Technology Inc
04.2003 - 10.2004
  • Answered a high volume of incoming calls and in-person inquiries from clients
  • Prepared receiving reports of incoming materials and equipment
  • Post inventory to appropriate client accounts
  • Separated and tore down bills to be distributed to the warehouse personnel and customer services representative for handling
  • Scheduled appointments for carrier pickup or delivery
  • Ensured drivers signed in and out on logs
  • Assigned and advised carriers of correct dock doors to load or unload products.

Sales Associate/Cashier

CVS Pharmacy
11.2002 - 04.2003
  • Handled opening and closing of cash drawer
  • Assisted customers with purchases and transactions
  • Developed customer service skills.

Office Manager

M&M Technology
09.2000 - 11.2002
  • Maintained all office files including personnel
  • Handled 401K enrolling process
  • Handled account payable and accounts receivable
  • Prepared weekly, monthly and yearly financial reports
  • Performed data entry and invoice entry
  • Ordered all office supplies to make sure office was properly stocked
  • Assisted Materials Coordinator with purchasing process
  • Set-up and managed accounts with various vendors
  • Processed incoming and outgoing mail, answered all incoming and outgoing calls
  • Greeting all clients.

Data Preparation Specialist

Wachovia Bank
01.1999 - 01.2000
  • Deposited checks into customers’ accounts based on account specific guidelines
  • Responsible for monitoring and reconciling customers’ accounts
  • Developed and enhanced PC skills.

Education

Studied - Information Processing Technology

Brookstone College of Business
Charlotte, NC

Studied - Computer Programming

Anson Community College

Certification - Medical Office Administration Specialist

University Of North Carolina
Charlotte, NC
01.2008

Skills

  • Word
  • Excel
  • IDX
  • Allscripts
  • Centricity
  • Stentor
  • E-time
  • Interaction Client
  • Labor Strategies
  • Viper
  • Epic
  • Canopy
  • Athena
  • Cerna
  • DDE
  • E-Services

Timeline

Talent Acquisition Specialist

Randstad
10.2022 - 08.2024

Insurance Verification & Billing Specialist

Novant Health Hospice Services
11.2020 - 10.2022

Referral Specialist

Charlotte Eye, Ears, Nose & Throat Associates
10.2018 - 11.2020

Care Coordinator / Surgery Scheduling Specialist

Atrium Health Care
07.2017 - 10.2018

Precertification & Referral Manager

Westmed Practice Partners
11.2015 - 01.2017

Managed Care Coordinator / Surgery Scheduling Specialist

Carolina Neurosurgery & Spine
04.2015 - 11.2015

Pre Registration & Benefits Verification Supervisor

Community Health Systems
07.2013 - 01.2015

Team Leader

OrthoCarolina
08.2006 - 01.2013

National Accounts Customer Service Representative II

Cigna Health Care
06.2004 - 01.2006

Shipping & Receiving Clerk

Distribution Technology Inc
04.2003 - 10.2004

Sales Associate/Cashier

CVS Pharmacy
11.2002 - 04.2003

Office Manager

M&M Technology
09.2000 - 11.2002

Proof Operator

Branch Banking & Trust
01.1999

Data Preparation Specialist

Wachovia Bank
01.1999 - 01.2000

Patient Services Coordinator

OrthoCarolina

Physician Referral Coordinator

OrthoCarolina

Appointment Scheduler

OrthoCarolina

Studied - Information Processing Technology

Brookstone College of Business

Studied - Computer Programming

Anson Community College

Certification - Medical Office Administration Specialist

University Of North Carolina

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Tamika Davis