Tamirra Singleton
Garland
Summary
Diligent Utilization Management Specialist with a proven track record of efficiently managing clinical administrative tasks. I demonstrate the ability to streamline office operations and enhance patient satisfaction. I utilize strong organizational and communication skills to support healthcare teams effectively.
I possess extensive experience in supporting clinical operations and optimizing office workflows. I am known for collaborative teamwork and adaptability, ensuring smooth transitions and reliable support.
Overview
7
7
years of professional experience
Work History
Clinical Administrative Coordinator
SSM Health
St. Louis, MO
05.2023 - Current
- As a Clinical Administrative Coordinator, it is my responsibility to receive urgent, routine, pre-service, and retro authorization requests and process them through the referral and authorization procedures as established by the medical group utilization department.
- Responsible for the intake of all new patient referrals received via email, fax, or phone.
- Responsible for the preparation and maintenance of specific reports to assist in the next level of review.
- Maintain and update the MD calendar so Central UM and Denial nurses can promptly schedule a peer-to-peer meeting.
- Determine financial responsibility in accordance with the medical group and follow up on authorization determinations so that billing can process the account promptly.
- Serves as backup to others within the UM department.
- Oversaw weekend activities to maintain operational efficiency and customer satisfaction.
Utilization Management Support Specialist II
Sutter Healthcare
Sacramento, CA
04.2022 - Current
- My job responsibilities as a Utilization Management Support Specialist II include accumulating, processing, interpreting, and documenting timely payer information to justify acute hospital admissions, need for continued stay, and proper level of care billing based on clinical outcomes. I am responsible for processing concurrent and retrospective denials in collaboration with clinical staff and internal physician advisors. I monitor and act as a liaison between leadership, external payers, staff, and other related services and departments to assist with troubleshooting, tracking, and trending the appropriate level of service, payer behavior, and identifying opportunities for improvement. I adhere to all local, state, and federal regulations, codes of conduct, policies, and procedures to ensure privacy and safety while delivering optimal patient care.
- Reviews all inbound payer communications through fax, email, voicemail, and payer portals.
- Accurately document payer status in a timely, effective, and efficient manner.
- Ensures timely uploading of clinicals to the payer portal and checking the portal for updated payer responses.
- Works all aspects of a payer correspondence from receipt to completion.
- Assist with drafting and revising the standard-of-work documents and training materials.
- Serve as a superuser for application upgrading, testing, validation, and implementation.
- Identified process improvement opportunities, implementing solutions that increased productivity across multiple departments.
- Serve as the department subject-matter expert for workflow processes.
- Consistently maintains productivity and quality standards.
- Coordinated administrative support for management, enhancing operational efficiency and streamlining communication processes.
- Developed and maintained comprehensive reports to track departmental performance metrics and operational outcomes.
- Facilitated training sessions for new staff, ensuring smooth integration into organizational processes and protocols.
Intake Specialist
BCBS of NC
North Carolina
11.2024 - 11.2025
- My job responsibilities as an Intake Specialist include supporting the incoming fax volume, specifically focusing on Behavioral Health requests.
- Process requests and inquiries via phone, email, and fax while maintaining quality and accuracy standards.
- Document information related to each case and attach supporting clinicals and documentation to the member’s account.
- Screen each fax request to determine if prior authorization is required.
- Verify member benefits and eligibility.
- Triage and complete all fax requests in a timely and efficient manner. Provide clinical review outcome notification to members and providers.
- Conducted comprehensive assessments of member needs to facilitate appropriate healthcare solutions.
- Coordinated intake processes, ensuring timely and accurate data entry into electronic health record systems.
Patient Care Coordinator
Genpact
Richardson, TX
11.2019 - 06.2022
- As a Patient Care Coordinator, my job responsibilities included providing new and existing patients with the best possible customer service regarding their drug prescriptions, catheter supplies, clinical services, billing inquiries, patient suggestions, and complaints, as part of the Special Handling or Drug/Disease-specific teams.
- Maintain positive relationships with referral sources.
- Conduct patient insurance verification and place medical supply reorders.
- Adhere to company policies regarding compliance and confidentiality.
- Records and processes orders and/or inquiries received by fax, mail, telephone, and/or through patient direct contact, as well as receives inbound calls to patients or MD Offices regarding orders for medications, pharmacy services, and all other inquiries.
- Coordinate patient care by scheduling orders, communicating information to the patient regarding shipments, assessing supply needs, verifying patient information, and notifying the pharmacist of issues or changes in the patient’s condition.
- Contact the pharmacists to alert them of any changes in the patient's condition, compliance issues due to the patient not taking medication, or side effects, or to transfer a patient directly to the pharmacist for counseling.
- Provides typed documentation of all communications received from calls and provides notification of any urgent orders, shipping-related issues, and any errors, complaints, or compliments to the appropriate party or system.
- Streamlined communication between healthcare teams, enhancing collaboration and patient experience.
Education
Master of Science - Health Administration Services
Strayer University
Dallas, TX03-2023
Bachelor of Business Administration - Health Administration Services
Strayer University
Dallas, TX09-2021
High School Diploma -
Garland High School
Garland, TX06-2013
Skills
- Excellent Communication Skills
- Ability to Work Under Pressure
- Decision Making
- Proficient in navigating EMR systems
- Time Management
- Proficient in Microsoft Software
- Conflict Resolution
- Teamwork
- Adaptability
- ICD-10 coding
- Medicare/Medicaid
- Clinical documentation
Timeline
Intake Specialist
BCBS of NC
11.2024 - 11.2025
Clinical Administrative Coordinator
SSM Health
05.2023 - Current
Utilization Management Support Specialist II
Sutter Healthcare
04.2022 - Current
Patient Care Coordinator
Genpact
11.2019 - 06.2022
Bachelor of Business Administration - Health Administration Services
Strayer University
Master of Science - Health Administration Services
Strayer University
High School Diploma -
Garland High School