TAN TRAN
Odessa,USA
Summary
Healthcare professional with 7+ years in medical insurance billing and revenue cycle management. Skilled in claim submission, denial resolution, and reimbursement accuracy. Fast learner with strong time management, adaptability, and a record of driving efficiency in high-volume environments
Overview
8
8
years of professional experience
1
1
Certification
Work History
Care Navigator
Optum
01.2023 - Current
- Coordinated patient care plans to enhance access to healthcare services.
- Facilitated communication between patients and healthcare providers to ensure continuity of care.
- Evaluated patient needs and recommended appropriate community resources and services.
- Developed educational materials for patients to improve health literacy and self-management skills.
- Led initiatives to enhance patient satisfaction metrics through targeted outreach and support programs.
- Consistently maintained confidentiality while handling sensitive patient information in accordance with HIPAA guidelines.
- Reduced hospital readmissions for patients through proactive follow-up and continuous communication.
- Educated member on gaps in care and assisted with scheduling provider appointments.
Medical Billing Specialist and Optical Technician
St. Michael's Eye And Laser Institute
03.2021 - 12.2022
- Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
- Managed accounts receivable, ensuring timely collection and updating of customer accounts.
- Obtained authorization/prior authorization for surgeries and testing.
- Making Out of Pocket payment for surgeries.
- Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
- Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process.
- Consulted and coordinated patient care with other physicians, pharmacists and specialists.
- Maintained high patient satisfaction through knowledgeable support and compassionate care.
Office Supervisor
Portland Eye Clinic
07.2017 - 03.2020
- Maintained thorough records of customer information, prepared detailed work payments, processed insurance claims and collected balances from customers.
- Entered procedure codes and diagnosis codes into medical billing software.
- Verified benefits and worked with insurance companies to obtain payments.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency
- Established workflow processes, monitored daily productivity and implemented modifications to improve overall performance of personnel.
- Analyzed data related to administrative costs and spending trends to prepare budgets for personnel.
- Set priorities and problem-solved workflow issues to maintain rapport with customers and managers.
- Double-checked forms for accuracy and completion in terms of admission, transfer and discharge of patients.
- Maintained patient databases and updated information in alignment with HIPAA protocols.
- Reviewed and sent medical records to other physicians upon request.
- Maintained optimal supply levels by closely monitoring and proactively replenishing supply inventory.
- Assisted with regulatory issues such as compliance.
- Provided administrative and accounting support, as required.
- Managed check-in and check-out procedures, verified patient information and submitted lenses orders.
Education
Bachelor of Science - Marketing Management And Research
USF
Tampa, FloridaBachelor Of Business Administration And Management - Marketing
Hoa Sen University
Ho Chi Minh12.2014
Skills
- Medical Billing and Collections
- Accounts Receivable Expertise
- Invoicing Proficiency
- Proficiency in billing system and CRM software (AdvanceMD, Salesforce, Office Ally)
- Expertise in Microsoft office
- Account Posting
Certification
Marketing Management And Research
LANGUAGES
English - Professional Working
Vietnamese - Native or Bilingual
Timeline
Care Navigator
Optum
01.2023 - Current
Medical Billing Specialist and Optical Technician
St. Michael's Eye And Laser Institute
03.2021 - 12.2022
Office Supervisor
Portland Eye Clinic
07.2017 - 03.2020
Bachelor of Science - Marketing Management And Research
USF
Bachelor Of Business Administration And Management - Marketing
Hoa Sen University
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