Tammie S. Madison
West Palm Beach,FL
Summary
To secure a challenging position in the medical field, where I can offer my skills and experience in a variety of medical settings. I can demonstrate effective communication among healthcare team members. Strengths include problem-solving, communication, multitasking, and interpersonal skills, coupled with a deep understanding of health insurance policies. Proven track record in improving operational efficiency and enhancing patient satisfaction.
Overview
23
23
years of professional experience
Work History
Lead Patient Access Representative
Conifer Health Solution/ St. Mary's Medical Center
West Palm Beach, Florida
06.2021 - Current
- Greeting customers, patient registration, explains, and secures hospital and patient legal forms.
- Obtain Consent for treatment. Provide patient financial counseling, education & referrals.
- Hospital cash reconciliation & secure payments entry in adherence to financial & cash control policies & procedures.
- Obtain insurance authorization for scheduled & unscheduled Hospital services and secures inpatient visit notification to payors.
- Revenue Cycle, Completes departmental operational report based on team performance accountability.
- Bed Placement, admission and transfer.
- Creates staff schedule, review time-off request and team huddles.
- Trained new hires on proper patient access protocols, procedures and customer service skills.
- Monitored changes in health care industry regulations that impact patient access services.
- Provided feedback to management regarding employee performance and customer service issues.
(Remote)-Insurance Verification Specialist
SCA Boca Raton Outpatient Surgery & Laser Center
Boca Raton, Florida
02.2015 - Current
- Verify that the correct insurance plan is selected in SIS by reviewing copies of insurance cards.
- Verify all patient insurance, both primary and secondary.
- Select the correct insurance carrier and payor contract.
- Calculate copays and deductibles. Notify patients of their financial responsibilities.
- Monitored changes in insurance companies and government regulations affecting healthcare reimbursement systems.
- Obtain insurance authorization for the scheduled appointment.
- Complete documentation in the computer system of insurance verification protocol and applicable financial responsibilities.
- Verify that the correct insurance plan is selected in SIS by reviewing copies of insurance cards.
- Communicate in writing or verbally, with on-staff physician offices, nurses, doctors, and staff regarding any changes to surgery scheduled and procedures.
- Monitored changes in government regulations affecting healthcare reimbursement systems.
- Assisted in resolving claim issues related to billing and reimbursement inquiries.
- Maintained confidentiality of patient information in accordance with HIPAA regulations.
- Researched third party payer guidelines related to prior authorizations, coding and billing processes.
Financial Review Coordinator / Collection & Insurance Specialist
Retina Group of Florida
Boynton Beach, FL
03.2006 - 02.2015
- Handle daily insurance verification processing for an 11 physician specialty practice
- Referral, Prior Notification & Pre-Determination coordination for all offices
- Preparation & request of injectable drug orders & other medications as prescribed
- Review all fee tickets on daily basis for accuracy
- Review daily cash & account balancing
- Post charges & payments on a daily basis
- Investigate all patient & insurance company requests for refund - prepare all required documents for final physician sign off
- Review daily claim entries for accuracy, submit claims electronically & via CMS 1500
- A/R review for outstanding claims payments including secondary & tertiary claims - investigation & claim payment resolution
- Heavy phone contact with various insurance carriers including commercial, Medicare & Medicaid carriers
- Assist patients with enrollment in payment programs including Chronic Disease Fund, Patient Access Network & Healthwell Foundation
- Credentialing & Recredentialing experience
- Daily contact with outside vendors & suppliers including Genentech, Allergan, Regeneron
- Clerical duties including heavy phone contact with patients for appointment scheduling & obtaining current insurance information
- Experience with EHR & a paperless office atmosphere
Front Desk & Medical Assistant
Sulayman E. Jallow, MD
Miami, FL
01.2003 - 01.2006
- Greet patients in timely & courteous manner
- Heavy phone interaction with patients & outside vendors
- Appointment scheduling & reminder calls
- Insurance verification for commercial, Medicare & Medicaid carriers
- Posted daily charges & patient payments
- Daily cash & account balancing
- Surgery schedule coordination
- Obtain all necessary referrals from primary care physicians
- Assist doctor with patient preparation including pretesting vision, history review & vitals
- Prescription ordering at Doctor’s request including specialty medications
- Administered dilating drops
- Visual Field Testing for all patients
Education
Some College (No Degree) - Code Enforcement Officer Certification
FL Association of Code Enforcement
West Palm Beach, FL11-2017
Associate of Science - Criminal Justice
Palm Beach State College
Lake Worth, FL09-2013
Some College (No Degree) - Law Enforcement Training Certification
Palm Beach State College
Lake Worth, FL09-2013
Medical Assistant Certification - Medical Assistant
Technical Career Institute
Miami, FL12-2000
High School Diploma -
Miami Jackson Sr. High School
Miami, FL08-1998
Bachelor of Science - Supervision and Healthcare Management
Palm Beach State College
Lake Worth, FLSkills
- Patient registration
- Customer service
- Insurance verification
- Financial counseling
- Revenue cycle management
- Hospital admission
- Employee scheduling
- Staff training and supervision
- Claims processing
- EHR management
- EMR system HST
- Cerna, MicroMD
- Nextech EMH
- Patient access solutions
- Waystar, Passport, Availity
- Surgery scheduling
- Authorization and notification of payor
- Medical billing, CMS, commercial payors
- AR management
- Credentialing
- Effective communication
- Problem solving
- Patient identity verification
- Multitasking and organization
Timeline
Lead Patient Access Representative
Conifer Health Solution/ St. Mary's Medical Center
06.2021 - Current
(Remote)-Insurance Verification Specialist
SCA Boca Raton Outpatient Surgery & Laser Center
02.2015 - Current
Financial Review Coordinator / Collection & Insurance Specialist
Retina Group of Florida
03.2006 - 02.2015
Front Desk & Medical Assistant
Sulayman E. Jallow, MD
01.2003 - 01.2006
Some College (No Degree) - Code Enforcement Officer Certification
FL Association of Code Enforcement
Associate of Science - Criminal Justice
Palm Beach State College
Some College (No Degree) - Law Enforcement Training Certification
Palm Beach State College
Medical Assistant Certification - Medical Assistant
Technical Career Institute
High School Diploma -
Miami Jackson Sr. High School
Bachelor of Science - Supervision and Healthcare Management
Palm Beach State College
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