Tamara Drummond
Summary
Experienced Internal and External Support Specialist
Overview
12
12
years of professional experience
1
1
Certification
Work History
Subject Matter Expert
Envision Healthcare
06.2015 - Current
- Successfully delivers reimbursement solutions for inpatient and outpatient medical care across all 50 states
- Partner with health care staff, insurance payers, and attorneys to identify and provide reimbursement solutions for patients being treated in a hospital setting
- Efficiently process claims for Hospitalist and Emergency Room Physicians
- Research and process patient eligibility, insurance coverage, claims, payor denials, and reimbursement from accounts as directed by policy and procedure; In collaboration and coordination with patient services to satisfy processing of each claim
- Compose appeal letters to third party payors by compiling proper materials
- Including claims forms, specific documents, and medical records as applicable to resolve complex payor and provider concerns
- Effectively understand the Physician billing process and ability to discern root causes of reimbursement issues
- Processed special projects as assigned by management such as write offs request to ensure for timely filing denials
- Train and mentor new employees on best practices for customer service and monthly incentive performances.
Correspondence Representative
Envision Healthcare
06.2013 - 06.2015
- Provided direct support to patients and their family members with understanding corresponding billing statements
- Serve as a main point-of-contact via phone for information, questions, status updates, and claim issues
- Obtain and process accounts according to action required to resolve account balance
- Manage claim denials by researching and confirming codes/charges
- Communicate with other departments, attorneys and insurance companies, as needed
- Gathered, reviewed, and processed payments for Healthcare Physicians located in Emergency Rooms Services.
Insurance Inquiry Representative
Envision Healthcare
03.2012 - 06.2013
- Managed a wide range of administrative, operational, and service functions with responsibility to data entry and management, reporting, and miscellaneous clerical support
- Entered and regularly updated information regarding patient demographics and health insurance within several computer systems
- Conducted patient outbound calls to obtain the source of medical insurance related to Worker's Compensation, Auto, Commercial, Medicaid, Medicare, Veteran's Affairs and etc
- Collected and secured payor information necessary to bill insurance in a timely matter.
Education
Temple University
Philadelphia, PAHigh School Diploma -
Murrell Dobbins
Philadelphia, PA06.1992
Skills
- Strategy and Planning
- Data Research and Collection
- Information Processing and Management
- Records and Reports
- Internal and External Communications
- Customer Service
- Account Management
- Prompt Issue Resolution
- Office Operations and Administration
- Support to all Office Staff
- Team Training and Leadership
- Office Technology
Accomplishments
- Consistently met or exceeded objectives in all positions.
- Earned high marks on employment reviews and excellent scores on surveys from internal and external contacts.
- Continually given leadership roles and management-level responsibility due to outstanding performance.
- Received promotions while working with Envision Healthcare.
- Maintained the highest level of accuracy in all data collection, entry, and management.
- Took on additional duties, often working extra hours to assist with special projects and overflow work.
- Regularly receive compliments from clients, managers, and colleagues for excellent results and service.
References
Excellent references and professional recommendations can be provided on request.
Certification
Certificate in HIPPA Compliance & Privacy, Code of Conduct, Annual Compliance Training, Workplace Violence and etc.
Additional Information
Summary of Qualifications:
T akes responsibility for actions: works independently and as a team player
A mbitious, prepared to meet deadlines and handle multiple tasks.
M otivated, confident and agreeable
A ccountable, organized and energetic
R eady to take on additional responsibilities
A rtistic, giving 100% of myself
Technical/Computer
Embillz, internal system similar to EPIC. Windows Operating Systems and Microsoft Office (Outlook, Word, Excel, PowerPoint)
Insurance Websites including and not limiting to Navinet, Availity, UHC, Multi-State Medicare, Medicaid Websites)
Zoom, Teams
Timeline
Subject Matter Expert
Envision Healthcare
06.2015 - Current
Correspondence Representative
Envision Healthcare
06.2013 - 06.2015
Insurance Inquiry Representative
Envision Healthcare
03.2012 - 06.2013
Temple University
High School Diploma -
Murrell Dobbins
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