Tammy McDougald
Peachtree Corners,GA
Summary
Ambitious and dedicated professional with extensive hands-on experience in providing support to a variety of complex medical groups and healthcare facilities. Highly skilled in managing front-office functions, including customer service, billing and collections, insurance and coding, and records management. Seeking to continue career in health administration with a respected organization dedicated to providing high-level care to diverse patient populations.
Overview
21
21
years of professional experience
1
1
Certification
Work History
Customer Support Specialist
Chenega Corporation Remote Night
Akaska, SD
04.2025 - Current
- Resolved customer inquiries through efficient use of ticketing systems and communication tools.
- Collaborated with cross-functional teams to enhance customer service protocols and streamline support processes.
- Trained new staff on customer engagement strategies and software usage to improve service delivery.
- Analyzed customer feedback to identify trends and recommend improvements for service quality.
- Implemented process enhancements that reduced average resolution time while maintaining high service standards.
- Delivered exceptional customer service experiences by maintaining a positive attitude, active listening skills, and empathetic responses to customer concerns.
- Enhanced customer satisfaction by addressing and resolving complex issues promptly and professionally.
- Handled escalated support cases with diplomacy and tact, successfully defusing tense situations between the company and its customers.
- Utilized CRM systems effectively to track customer interactions, document detailed case notes, and access relevant account information quickly when needed.
- Implemented effective troubleshooting techniques for faster problem resolution and improved customer satisfaction levels.
Project Manager - EPIC Live Conversion - Remote, Contractor
University of Cleveland Ohio
08.2023 - Current
- Lead virtual chat assistant operations for UHH Secure Chat, ensuring seamless communication and support
- Manage MyChart activations, deactivations, and proxy additions/deletions to ensure accurate and secure user profiles
- Provide comprehensive training to MyChart users, enhancing their proficiency and utilization of platform
- Oversee EPIC scheduling, cancellation, and coordination of appointments across various departments within the University Hospital Secure system
- Conduct weekly staff meetings to streamline communication and address project-related updates and challenges
- Resolve issues with patients promptly, leveraging effective communication and conflict resolution skills
- Create and resolve Customer Relationship Management (CRM) cases for each account through live chat and incoming calls, ensuring efficient and satisfactory resolutions
EPIC Insurance Verification Supervisor - Remote, Contractor
University of Cleveland Ohio
04.2023 - 08.2023
- Spearheaded and directed a team of 50 employees, providing leadership and guidance in EPIC training for Insurance Verification
- Executed comprehensive eligibility and insurance verification processes, ensuring accurate and timely support to facilitate payment
- Leveraged EPIC system to initiate proactive communication with patients, obtaining crucial policy details, plan specifics, and group numbers for all insurance carriers to verify eligibility
- Established and maintained robust communication channels with both insurance carriers and patients, utilizing websites to conduct thorough insurance benefit verification across all carriers
- Collaborated seamlessly with internal and external stakeholders to address patient inquiries and route patients to appropriate departments when necessary
- Oversaw and managed referrals, authorizations, and demonstrated expertise in CPT, HCPCS, and ICD-10 coding while adhering to HIPAA guidelines and ensuring compliance with healthcare regulations
- Served as Executive Assistant to Director of Insurance, providing calendar management, travel arrangements, board meetings, and updating staff of meeting times and priority, as well as researching and preparing materials for executive management
Claims Examiner I
Premier Healthcare Inc.
05.2022 - 01.2023
- Provided expertise and general claims support by reviewing, researching, investigating, and processing claims to consistently meet established productivity and quality standards
- Performed research to analyze coverage and liability while demonstrating a high level of investigation, analysis, evaluation, and negotiation to ensure payment accuracy
- Thoroughly analyzed and processed complex claims according to business regulations, internal standards, and examining guidelines in order to identify discrepancies prior to processing
- Resolved claims edits and deferrals by performing research on claim problems and coordinating with various internal support areas
Lead Navigator - Remote Clinic Manager
Health Wealth Safe
05.2020 - 05.2022
- Managed prescription refill requests and Telemedicine appointments, screening patients using health and diagnosis questionnaire via phone communication and documenting health issues with patients and navigating to the appropriate clinic staff per patient needs
- Served as liaison to support internal communication between mobile services program, patient navigation center and clinic staff
- Linked patients to Registration, Chronic Care Management and Support Center, assisting patients with Chats, website, automated call and telemedicine issues
- Coordinated engagement and follow-up with participants, assisting participants with support center contacts as needed for proper enrollment services and overseeing steps to register for RPM and TM
- Coordinated learning sessions for patients to teach them how to engage with the website properly and update their wellness questionnaires as required
- Provided administrative assistance to virtual providers with referrals and initiated authorization requests as appropriate
Blue Cross Blue Shield Billing Analyst - Contractor
North Atlanta Primary Care
06.2021 - 09.2021
- Tracked, monitored and scheduled follow-ups for all Remote Monitoring patients discharged from the hospital or ER
- Worked in insurance module on claims with high dollar amounts, clearing older dates of service and ensuring current claims issued were followed up on
- Processed claims in BCBSNC and Medicaid databases that did not submit electronically
- Resubmitted corrected claims for adjudication to insurance carriers, appealed denied claims and submitted secondary claims with primary EOBs for payment
- Wrote off balances to specific accounts as requested
- Worked all inquiries from insurance carriers both in and out of state, placing calls to insurance companies for resolution on appeals, corrected, and denied claims
Patient Qualification Agent (Remote)
StudyKik Clinical Trials
06.2018 - 10.2019
- Conducted calls to potential patients who expressed interest via lead generation process
- Pre-screened patients for clinical trial eligibility, conducting case studies for patients and tracking, remotely monitoring and scheduling follow-ups
- Input and updated patient information in computer system, verifying documents were accurate and complete
- Provided general administrative support to clinical trial staff and project managers
Laboratory Toxicology Testing Technician - Contractor
Living Well Psychiatry – Salvus Labs
06.2018 - 10.2018
- Provided toxicology testing, ensuring the highest standard of care for patients via urine and mouth swab testing
- Followed established procedures for specimen handling and processing, testing analyses, and reporting and maintaining records of patient test results
- Analyzed laboratory findings and verified results accuracy
- Entered and observed data from analysis of medical tests and clinical results into database
- Established and monitored quality assurance programs and activities, performing quality control procedures and standard preventative maintenance
Medical Billing Representative
Duke University
02.2017 - 07.2018
- Prepared and submitted billing data and medical claims to insurance companies, maintaining communication regarding outstanding balances
- Performed data entry for charges, payment denials and adjustments, investigating and appealing denied claims
- Ensured patient medical information was accurate and up to date, resolving issue regarding patient insurance and billing information
- Assisted in general administrative activities, answering calls and utilizing EPIC EHR software
Patient Financial Specialist
Atlantic Health Systems
06.2005 - 03.2011
- Answered calls, verified insurance coverage, and managed patient accounts, screening patients for new program eligibility
- Advised and assisted patients on medical billing obligations regarding services, noting all accounts with accurate and detailed descriptions of actions taken and maintaining open communication with patients to keep them informed of any issues with their claims
- Completed professional development activities and maintained required professional certifications
- Created CRM’s, Chase Manhattan, IDK, fax and scans, billing statements, management, accounts receivable, and collections from third parties while maintaining confidentiality
Education
undefined
Skills
Bilingual – Spanish and English
Microsoft Office Suite – 60 WPM
Basic Coding for ICD
Medical Billing
Medicare and Medicaid
Claims Appeal
Medical Record Management
EHR/EMR
HMO and PPO
CMS1500 Claim Form
HIPAA Compliance
Accounts Payable
Release of Information
Greenway Prime SUITE
Patient Processing & Registration
Medical Laws & Ethics
Pathophysiology for Medical Office
Medical Transcription
ICD-9 and ICD-10
Third Party
Clerical & Administrative Duties
Customer Service and Patient Experience
Telemedicine
Test Results Interpretation
Claims Examiner I
Provider Onboarding Specialist/Provider Credentialing
Health Pac
MS Teams
EDI
Salesforce
National CPC
Virtual Chat Assistant
EPIC (Hyperspace)
Sorian Financials
MD Fits
Cisco Finesse
Cisco Jabber
Outlook Web Access
University Hospitals Digital Workplace
MS 365
Kronos
VPN
VDI
Sentinel One Agent
Certification
Certified Lash Technician - Georgia
Timeline
Customer Support Specialist
Chenega Corporation Remote Night
04.2025 - Current
Project Manager - EPIC Live Conversion - Remote, Contractor
University of Cleveland Ohio
08.2023 - Current
EPIC Insurance Verification Supervisor - Remote, Contractor
University of Cleveland Ohio
04.2023 - 08.2023
Claims Examiner I
Premier Healthcare Inc.
05.2022 - 01.2023
Blue Cross Blue Shield Billing Analyst - Contractor
North Atlanta Primary Care
06.2021 - 09.2021
Lead Navigator - Remote Clinic Manager
Health Wealth Safe
05.2020 - 05.2022
Patient Qualification Agent (Remote)
StudyKik Clinical Trials
06.2018 - 10.2019
Laboratory Toxicology Testing Technician - Contractor
Living Well Psychiatry – Salvus Labs
06.2018 - 10.2018
Medical Billing Representative
Duke University
02.2017 - 07.2018
Patient Financial Specialist
Atlantic Health Systems
06.2005 - 03.2011