Tanvi Tandan
Morris Plains
Summary
An organized and motivated individual, eager to utilize time management and organizational skills across diverse settings. Seeking entry-level opportunities to enhance abilities while contributing to company growth.
Overview
3
3
years of professional experience
1
1
Certification
Work History
Insurance Specialist - Home Care and Finance
Atlantic Health System
Morris Plains
02.2025 - 12.2025
- Function as a liaison between external Insurance Companies and internal staff to ensure patient needs are met.
- Communicate with clinical teams to request necessary information for ongoing authorizations in a timely manner.
- Verifies patient insurance for all incoming referrals, for all payers.
- Verifies patient insurance during the course of the episode if a payer change occurs, or a need for reverification arises.
- Participates in the re-verification at designated times of the year, i.e., open enrollment period.
- Documents all verification information in EPIC to ensure CAC, clinical teams, and other departments are aware of results.
- Documents all authorization information in Epic to ensure clinical communication, as well as accurate system notification of ongoing needed authorization.
- Reviews additional service requests for completeness of information, accuracy, and presence of required clinical data.
- Request and/or submit clinical documentation for authorization or reauthorization in Epic, and prepare updates as indicated.
- Manages assigned patient, insurance, and/or account EPIC work queues, ensuring accurate and timely completion.
Insurance Specialist
Atlantic Health System
Morris Plains
02.2024 - 02.2025
- Created DME rental claims and reviewed them for accuracy; transmitted and submitted electronic and paper claims.
- Reviewed order/progress notes for pre-bill review of DME; corrected claim errors to meet payer rules.
- Managed compliance requirements for equipment (sleep apnea/PAP therapy) to assure accurate billing.
- Obtained prescriptions, certificates of medical necessity (CMN) from physicians' offices and facilities.
- Reviewed reports of held revenues, ensured timely billing of claims, and reduced bad debts.
- Submitted appeals on DME coverage guidelines, medical policies, for expedited claims processing.
- Reported errors/delays for claims rejection/correction (missing modifiers, pricing discrepancies).
Patient Care Coordinator
Atlantic Health System
Morris Plains
10.2022 - 01.2024
- Processed new orders/re-orders; maintained good relationships w/patients, care givers and referrals.
- Qualified patients for the equipment ordered based on the information received.
- Obtained the added documentation needed to qualify patients based on their insurance coverage.
- Entered patient and order systems data in the applications and computer systems.
- Printed order tickets and other required forms for delivery.
- Documented all communications via the notes section and the minutes of the meetings sections.
- Communicated with patients, physicians, discharge planner and other referral sources to obtain information necessary to process orders and re-orders.
Education
M.P.A. - Public Administration
Kean University
Union05-2022
B.A. - Public Administration
Kean University
Union01.2021
Skills
- Insurance Verification
- Clinical Documentation
- Customer Relationship Management
- Time Management
- Problem Solving
- Authorization Management
- Data Entry Accuracy
Certification
• Medical Coding and Billing Certificate, 2022
Timeline
Insurance Specialist - Home Care and Finance
Atlantic Health System
02.2025 - 12.2025
Insurance Specialist
Atlantic Health System
02.2024 - 02.2025
Patient Care Coordinator
Atlantic Health System
10.2022 - 01.2024
M.P.A. - Public Administration
Kean University
B.A. - Public Administration
Kean University