Tamra Powell
Brandon,FL
Summary
Astute insurance professional offering 10 + years in customer care, data entry and processing insurance claims. Skilled at helping patients feel comfortable with knowledgeable assistance. Detailed Data Entry Clerk with experience inputting and organizing data in various software and applications. Results-driven Data Entry Clerk with extensive database management expertise. Hardworking employee with customer service, multitasking, and time management abilities. Devoted to giving every customer a positive and memorable experience. Proven history of successful error detection and correction. Extensively trained in transcription, word processing and spreadsheets.
Overview
11
11
years of professional experience
Work History
Insurance Specialist II
AbbVie Endocrinology
09.2023 - Current
- Provide subject matter expertise on claim billing, insurance coverage/verification, prior authorization and appeal filing, and limited financial assistance opportunities such as (PAP, LIS, Independent Copay foundation, Copay Cards, etc.)
- Communicate with insurance payors and providers to investigate pharmacy and medical benefits.
- Determine patient's financial responsibilities, quantity limits, and prior authorization or pre-certification requirements.
- Meet performance standards in alignment with predefined metrics.
- Utilize the appropriate web tools to assess and determine patient eligibility and insurance benefits
Patient Access Service Representative III
Quest Diagnostics
08.2022 - 09.2023
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Performed patient scheduling and registration functions to serve as initial contact point for medical office visits.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations.
Customer Service Specialist II
Leading Edge Administrators
11.2021 - 07.2022
- Communicated with pharmacies or medical offices through inbound and outbound calls and written communications responding to customer questions and helping to resolve their problems using the computer system to track, gather information and/or trouble-shoot issues for customers.
- Reviewed processed claims to identify payment information, denial reasons, claim errors, etc.
- Promptly answered patients' billing and medical questions with strict adherence to confidentiality agreements, HIPAA, and policies and procedures.
Medical Claims Processor
Medwatch LLC
07.2019 - 11.2021
- Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
- Managed large volume of medical claims on daily basis. Paid or denied medical claims based upon established claims processing criteria.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Prepared insurance claim forms or related documents and reviewed for completeness.
Data Entry Clerk
Continental Benefits
03.2013 - 06.2019
- Performed data entry from paper documents, emails, and other sources into computer systems.
- Maintained database by entering new and updated customer and account information.
- Checked source documents against entered data to ensure accuracy.
- Identified and corrected data entry errors to prevent duplication across systems.
- Remained focused for lengthy periods to accurately perform work with adequate speed.
Education
Bachelor of Science - Radiation Therapy
Hillsborough Community College
Tampa, FL05-2027
Skills
- Reporting Abilities
- Documentation Abilities
- Regulatory Compliance Understanding
- Account Management Expertise
- Error Identification
- Document Processing
- Maintains Confidentiality
- Professional and Mature
- Complaint Resolution
- Scheduling
- Inbound and Outbound Calling
- Data Entry
- Call Management
- De-Escalation Techniques
- Microsoft Outlook
- Customer Service
Timeline
Insurance Specialist II
AbbVie Endocrinology
09.2023 - Current
Patient Access Service Representative III
Quest Diagnostics
08.2022 - 09.2023
Customer Service Specialist II
Leading Edge Administrators
11.2021 - 07.2022
Medical Claims Processor
Medwatch LLC
07.2019 - 11.2021
Data Entry Clerk
Continental Benefits
03.2013 - 06.2019
Bachelor of Science - Radiation Therapy
Hillsborough Community College
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