TAMINKA MCLUCAS

• Process and post payments from insurance companies and patients, ensuring accuracy and timeliness.
• Analyze and reconcile payment batches against EOBs to identify and resolve discrepancies.
• Maintain detailed payment logs and collaborate with accounting for month-end reporting.
• Conduct periodic billing audits to improve posting accuracy and reduce outstanding balances.
• Utilized electronic health record systems for efficient data entry and tracking.
• Collaborated with insurance providers to clarify payment guidelines and resolve claims issues.
• Maintained comprehensive records of payments received and adjustments made.
• Implemented process improvements to enhance accuracy and efficiency in payment processing.
• Managed large volumes of data efficiently and with great care on daily basis.
• Communicated effectively with others through active listening and dynamic interpersonal skills.
• Verified accuracy of accounts payable payments, resulting in 25% reduction in payment errors and check reissues.

• Streamlined patient registration processes, enhancing efficiency and reducing wait times.
• Led team in implementing electronic health record systems, improving data accuracy and accessibility.
• Developed training programs for new staff, fostering knowledge retention and operational consistency.
• Collaborated with clinical teams to optimize patient flow, ensuring timely access to care services.
• Analyzed patient access metrics to identify areas for improvement, driving strategic initiatives for service enhancement.
• Managed scheduling protocols, balancing patient needs with resource availability to maximize operational efficacy.
• Established key performance indicators for department functions, tracking progress towards organizational goals and objectives.
• Trained and mentored new employees in registration department, answered questions and provided insight on patient services.
• Observed all facility rules and regulations regarding patient data to promote confidentiality and integrity.
• Educated all registration staff personnel regarding updates and changes to job positions.
• Developed highly effective communication, interpersonal, and active listening skills, which were used for interacting with people of all different backgrounds and cultures.

• Coordinated pre-authorization and insurance verification for surgical procedures.
• Monitored financial clearance metrics to ensure proper reimbursement before scheduling.
• Designed scheduling templates and trained staff to improve data accuracy and minimize denials.
• Collaborated with billing teams to reconcile pre- and post-operative claims.
• Coordinated with facilities to set up surgeries for 15+ daily for multiple surgery types, for example, Orthopedic, Cosmetologic, ENT, etc..
• Answered phone calls and messages for 20 physicians at a medical facility, scheduling appointments and handling patient inquiries.

• Processed patient registrations and verified eligibility, insurance benefits, and authorizations.
• Ensured claim accuracy through timely collection of demographic and coverage details.
• Assisted finance team with audit preparation and claim documentation.
• Maintained compliance with HIPAA and payer policy standards.

Verified patient insurance coverage and eligibility for medical services

• Collaborated with healthcare providers to resolve insurance discrepancies
• Trained junior staff on best practices for insurance verification procedures
• Analyzed claims data to identify trends and reduce rejections
• Trained new staff on current, correct insurance verification procedures.
• Fostered strong relationships with insurance companies to expedite authorization requests
• Ensured compliance with HIPAA regulations while managing sensitive patient information during the verification process.
• Assured timely verification of insurance benefits prior to patient procedures or appointments.
• Updated patient records with accurate, current insurance policy information.
• Maintained strong knowledge of basic medical terminology to better understand services and procedures.
• Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
• Collaborated with team members to resolve discrepancies in insurance verification, ensuring proper billing practices.
• Managed approximately 60+ incoming calls, emails, and faxes per day from all customer types.

• Led cross-functional teams to enhance operational efficiency and streamline processes.
• Developed training materials and conducted workshops for staff on best practices and compliance standards.
• Analyzed industry trends to inform strategic decision-making and optimize service offerings.
• Developed effective training materials for diverse audiences, resulting in improved skillsets and increased job satisfaction.
• Implemented mentoring program for junior staff, accelerating their professional development and contribution to projects.
• Mentored junior staff, fostering professional growth and enhancing team capabilities.
• Evaluated performance metrics to drive continuous improvement initiatives across departments.
• Mentored junior team members, contributing to their professional growth and development.
• Established best practices for knowledge sharing, fostering a culture of continuous learning and improvement.

• Coordinated patient care with payers, advocating for service coverage and reimbursement.
• Utilized analytical tools to track case outcomes and payer approval rates.
• Oversaw case management processes, ensuring compliance with regulatory standards and organizational protocols.
• Developed and implemented care plans tailored to individual patient needs, enhancing overall quality of care.
• Analyzed case data to identify trends, informing strategic decisions for resource allocation and program improvement.
• Provided mentorship and training to junior case managers, fostering professional development and team effectiveness.
• Advocated for patients' interests by facilitating communication between healthcare providers and families, ensuring clarity in care approaches.
• Identified patterns of denied coverage and escalated systemic issues to leadership.

• Managed staff schedules, payroll, and daily financial reporting.
• Supervised front desk operations, ensuring efficient check-in and check-out processes.
• Trained and mentored staff on customer service best practices and hotel policies.
• Coordinated with housekeeping and maintenance teams to ensure room readiness and guest satisfaction.
• Developed training materials for new employees to standardize operational procedures.
• Monitored inventory of supplies, ordering as necessary to maintain adequate stock levels.
• Resolved guest complaints effectively, enhancing overall guest experience and retention rates.
• Trained new employees on front desk operations, ensuring they were well-prepared for their roles and responsibilities.
• Trained new staff on correct procedures, compliance requirements, and performance strategies.
• Provided exceptional customer service, leading to positive online reviews and repeat business from satisfied guests.
• Resolved guest complaints with tact and diplomacy, maintaining a positive image for the hotel brand.
• Scheduled and assigned daily work and activities for team members.
• Assisted in increasing room occupancy rates by proactively upselling available rooms and services to potential guests.
• Conducted audits and reconciled accounts to maintain accuracy and accountability.
• Strengthened service workflows that reduced guest billing discrepancies by 30%.
• Oversaw front desk operations, ensuring exceptional guest service and satisfaction.