Tanisha Dixon
Burtonsville,MD
Summary
Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Reimbursement Case Advocate
Smith & Nephew, Inc
, MD
01.2023 - Current
- Applied HIPAA privacy and security regulations while handling patient information.
- Applied knowledge of payer requirements and utilized on-line eligibility systems to verify patient coverage and policy limitations.
- Called insurance companies and verified patient coverage.
- Performs a detailed insurance benefit verification for all products including obtaining patient responsibility, researching payer coverage criteria, and any required prior authorization requirements
- Maintain clear documentation of all tasks, review reports for accuracy and completeness, prepare and send insurance benefit verification results to healthcare providers, and protect PHI, all within the departments directed time allotment.
- Reports any payer delays/ reporting challenges and escalates complaints accordingly to Team Lead and/or Supervisor as necessary.
- Collaborates with Market Access and Field Reimbursement teams to further investigate reporting issues or change in payer coverage criteria
Clinical Resource Consultant Data Entry Specialist
CTI Clinical Trial and Consulting
, United States
04.2021 - 04.2022
- Enter or verify CRF's into the clinical database
- Perform CRF inventory
- Assist the Clinical Data Manager
- Work with site and CTI staff to resolve queries in the clinical database
- Efficiently and accurately enter data into clinical database systems
- File and archive study documentation
Patient Access Specialist
AstraZeneca
Gaithersburg, United States
09.2018 - 08.2020
- Perform intake of cases and capture information in Access360 Case Management system.Manage day to day activities of health care provider support requests and deliverables across multiple communication channels i.e Phone, fax Chat, email, etc
- Communicate effectively with Payers, third party administrators and other departments .Perform in-depth research into patient's insurance, prior authorization and appeal requests on behalf of provider .Educate offices on Access 360 programs and referral process to ensure timely case processing
Team Leader
Children's National Medical Center
Laurel, United States
01.2016 - 08.2018
- Supervises a staff of customer service representatives and ensures customers are satisfied
- Responsible for training customer service representatives, and for developing and implementing operations and policies
- Verify Insurance eligibility
- Exceed goal of obtaining authorizations five days in advance of services
- Collect and record payments helping department meet 85% collection target
- Reconcile charges
- Reconcile daily cash receipts/ collections
- Educate staff on OSHA procedures
- Monitor and correct registration errors
- Monitor QA reports
- Train and mentor peers
- Monitor staff performance
- Implement performance improvement action plan
- Assume leadership role in absence of manager.
Gastroenterology Call, Children's National Medical Center
, United States
12.2011 - 01.2016
- Review and Correct Physician schedules
- Orient staff to clinic guidelines
- Monitor Staff calls
- Maintain accurate clinic operations manuals and training materials
- Educate staff and escalate compliance concerns to management
- Assist staff with escalated customer concerns
- Act as a liaison between Management, staff, physicians, and clinicians and families
- Train New hires
- Supervise call queue and direct staff according to the needs of the queue Act as team leader in the absence of the manager
- Assist with miscellaneous tasks as needed
Call Center Representative
Children's National Medical Center
Silver Spring, United States
02.2010 - 12.2011
- Register and schedule patients by telephone utilizing the physician scheduler Sci system, and individual departmental procedures for the specialty clinics of Children's National Medical Center
- Verify financial and insurance information and provide basic insurance plan education to customers
- Answer a minimum of 40 calls per day within less than 30 seconds Meet call quality standard of 90% or greater
- Register appointment with 100% accuracy Maintain a productivity rate of 85% or higher
Education
Bachelor's in BS - Healthcare Administration Management
01.2022
06.1995
Skills
- Customer Service Oriented
- Patient Confidentiality and Data Security
- Registration and Scheduling
- Organized and Detail-Oriented
- Database Search and Data Entry Skills
- Calm and Effective Under Pressure
- Case Management Experience
- Microsoft Outlook Microsoft Powerpoint Microsoft Word MS Word
Certification
Systems Management Data Integrity Database Database Systems Microsoft Access CTI
Conditional Random Field CRF Coding Drivers Queue Management Queue EPIC IDX Cerner
Mckesson Data Collection Electronic Health Records EHR Spring Salesforce EMR CSS LESS
Healthcare Healthcare Management Medical Billing Case Management Office Medical
Medical Terminology CPT Gastroenterology Clinical Trials GCP Clinical Research Clinical Trial
ICD-9 CPT-4
Languages
Timeline
Reimbursement Case Advocate - Smith & Nephew, Inc
01.2023 - Current
Clinical Resource Consultant Data Entry Specialist - CTI Clinical Trial and Consulting
04.2021 - 04.2022
Patient Access Specialist - AstraZeneca
09.2018 - 08.2020
Team Leader - Children's National Medical Center
01.2016 - 08.2018
- Gastroenterology Call, Children's National Medical Center
12.2011 - 01.2016
Call Center Representative - Children's National Medical Center
02.2010 - 12.2011
University of Maryland-University College - Bachelor's in BS, Healthcare Administration Management
Montgomery Blair High School - ,
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