TANGELA PARKER
Houston,TX
Summary
Knowledgeable and dedicated customer service professional with extensive experience in 10 industry. Solid team player with outgoing, positive demeanor and proven skills in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality, speed and process optimization. Articulate, energetic and results-oriented with exemplary passion for developing relationships, cultivating partnerships and growing businesses.
Overview
10
10
years of professional experience
Work History
Managed Care Representative II
Kelsey Seybold
Pearland, TX
01.2020 - Current
- Managed Care Representatives respond to inquiries from health plan members, providers and various customers while consistently meeting productivity, quality and service standards
- Knowledge of Texas Department of Insurance and ERISA Regulations
Excellent interpersonal skills to interface with physicians. Strong ability to actively listen to customers, probe for clarification, and provide consultative guidance based upon customers inquiries. - Managed Care Representatives handle member and provider calls for self-funded, fully insured and Medicare Commercial plans.
- Managed over 50 customer calls per day.
- EPIC” Tapestry Experience
- Excellent communication and listening skills
CUSTOMER SERVICE/ TEAM LEAD/ SUPPORT
Acclara Solutions
Houston, Texas
11.2018 - 01.2020
- Manage multiple and changing priorities in addition to maintaining absolute integrity in working with confidential information
- Assisting team members with analyzing patient account information, researching claims, and initiating actions needed to get payment on claims resolved
- Receive inbound and outbound calls from customers relating to billing statements
- Duties include examining monthly statements and making critical decisions regarding accuracy. Accurately responding to patient's online email inquiries regarding payment, coding and insurance concerns through MyChart portal
- Collection of payment and reconciliation of accounts varying complexity, while preparing and processing eligibility changes to minimize financial impact to patients.
MEDICAL BILLING AND CODING SPECIALIST
Timothy Anderson M.D. P.A
Houston, Texas
06.2012 - 09.2018
- Kept all files secure and confidential to protect patients and comply with HIPAA and internal requirements
- Followed-up on claims submitted to insurance companies to mediate disputes and obtain reimbursement for services rendered during patient's treatment
- Assembled data concerning patient's bill, including hospital stay, consulted doctor, processed payments, and insurance billing information
- Worked with medical coder to review clinical statements and assigned standard codes using CPT, ICD-10-CM or HCPCS Level II system,
- Verified coverage with insurers, filed required forms, and submitted paperwork to obtain timely payments
- Explained charges to patients and collected payments.
Education
ICD -
Everest Institute
Houston, TX05.2011
Skills
- Coding Medical Laws and Ethics HIPAA,
- CMS-1500 Forms
- Account Reconciliation
- Medical Terminology
- Epic
- Managed Care
- Policy Modifications and Updates
- Insurance Processing
- Coverage Determination
- Patient Information
- Eligibility Determinations
Timeline
Managed Care Representative II
Kelsey Seybold
01.2020 - Current
CUSTOMER SERVICE/ TEAM LEAD/ SUPPORT
Acclara Solutions
11.2018 - 01.2020
MEDICAL BILLING AND CODING SPECIALIST
Timothy Anderson M.D. P.A
06.2012 - 09.2018
ICD -
Everest Institute
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