Tangela Glenn
Harrisburg,NC
Summary
Experienced with handling complex precertification procedures in healthcare sector. Utilizes meticulous attention to detail and effective communication to ensure timely insurance approvals. Track record of navigating regulatory requirements and fostering professional relationships within medical and insurance fields.
Overview
16
16
years of professional experience
Work History
Precertification Specialist
Carolina Neurosurgery & Spine Associates
01.2019 - Current
- Maintained strict adherence to HIPAA regulations by safeguarding confidential patient information during all aspects of the precertification process.
- Facilitated successful appeals for denied services by providing detailed documentation supporting medical necessity as required by insurers.
- Conducted thorough follow-ups with insurance companies, ensuring timely receipt of authorization numbers for approved services.
- Mitigated potential delays in service delivery through proactive identification of potential roadblocks within the precertification process.
- Streamlined precertification processes by implementing efficient tracking systems and prioritizing urgent cases.
Patient Care Coordinator
Lash Group
08.2017 - 01.2019
- Engaged with patients to provide critical information.
- Delivered support to medical staff in completion of patient paperwork.
- Helped address client complaints through timely corrective actions and appropriate referrals.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Compiled and maintained patient medical records to keep information complete and up-to-date.
- Verified patient insurance eligibility and entered patient information into system.
- Ensured compliance with healthcare regulations and patient privacy laws, maintaining safe and confidential environment.
- Enhanced patient satisfaction by coordinating timely care and addressing individual needs.
- Optimized resource allocation, ensuring that necessary medical supplies were always available for patient care.
- Managed patient records with strict adherence to confidentiality and accuracy standards.
Precertification Specialist
Mod Medicine
04.2014 - 06.2017
- Maintained strict adherence to HIPAA regulations by safeguarding confidential patient information during all aspects of the precertification process.
- Facilitated successful appeals for denied services by providing detailed documentation supporting medical necessity as required by insurers.
- Developed comprehensive knowledge of various insurance plans, policies, and coverage limitations to provide accurate guidance to patients and providers.
- Conducted thorough follow-ups with insurance companies, ensuring timely receipt of authorization numbers for approved services.
- Ensured smooth communication between healthcare providers, patients, and insurance companies, resulting in timely approvals and positive experiences.
- Reduced patient wait times for approval by diligently reviewing medical records and obtaining necessary documentation.
- Expedited treatment commencement by promptly acquiring authorizations for medically necessary services within required timeframes.
Precertification Specialist
Carolina Digestive Health Associates
01.2009 - 04.2014
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
- Reduced patient wait times for approval by diligently reviewing medical records and obtaining necessary documentation.
- Expedited treatment commencement by promptly acquiring authorizations for medically necessary services within required timeframes.
- Ensured smooth communication between healthcare providers, patients, and insurance companies, resulting in timely approvals and positive experiences.
- Contributed extensively to departmental goals through consistent achievement of individual performance benchmarks related to precertification accuracy and timeliness.
Education
High School Diploma -
Redford High School
Detroit06.1978
Skills
- Prior Authorization Knowledge
- Strong Communication Skills
- HIPAA compliance awareness
- Patient Confidentiality Adherence
- Insurance Verification Expertise
- Professionalism and Ethics
- Documentation and paperwork
- Organization and Time Management
- Clinical Documentation
Additional Information
I have been able to start a 501c3 outreach program in which I have been able to feed and cloth the homeless.
We feed 100 homeless individuals twice a month and provide clothing, toiletry items and offer spiritual guidance
for those who will accept it.
Timeline
Precertification Specialist
Carolina Neurosurgery & Spine Associates
01.2019 - Current
Patient Care Coordinator
Lash Group
08.2017 - 01.2019
Precertification Specialist
Mod Medicine
04.2014 - 06.2017
Precertification Specialist
Carolina Digestive Health Associates
01.2009 - 04.2014
High School Diploma -
Redford High School
Similar Profiles
Daphne BaumDaphne Baum
New Patient Coordinator at Carolina Neurosurgery & Spine AssociatesNew Patient Coordinator at Carolina Neurosurgery & Spine Associates
Susan StephensSusan Stephens
Operations Coordinator (Remote) at Carolina Neurosurgery And Spine AssociatesOperations Coordinator (Remote) at Carolina Neurosurgery And Spine Associates
Martrice HunterMartrice Hunter
Front Desk Receptionist at Carolina NeuroSurgery & Spine AssociatesFront Desk Receptionist at Carolina NeuroSurgery & Spine Associates