Tanya Johnson-Haye
Bronx,USA
Summary
Certified Professional Coder and biller with extensive experience in healthcare medical coding across various CMS place of service settings. Proficient in patient registration and revenue cycle management, including accounts receivable, payer policies, and denial management. Demonstrated expertise in insurance screening, verification, pre-authorization, and referrals, complemented by advanced knowledge of private, commercial, and exchange plans, as well as Medicare and Medicaid managed care. A strong understanding of payment models enhances the ability to navigate complex billing environments effectively.
Overview
24
24
years of professional experience
1
1
Certification
Work History
Billing Coordinator
NYU Langone Hospital System and NYU School of Medicine
05.2021 - Current
- Perform billing tasks assigned by management, which may include data entry, claim review, charge review, accounts receivable follow-up, or other related responsibilities.
- Participate in workgroups and meetings. Attend all required training classes. Escalate issues to management as needed. Maintain confidentiality.
- Read and apply policies and procedures to make appropriate decisions. Coordinate functions and work cooperatively with others.
- Explain processes and procedures to others; performs other related duties as assigned.
- Work following operational policies and procedures, and regulatory requirements.
- Ensure that items in assigned work queue(s) are resolved within required timeframes using payer website, billing systems, and CBO pathways.
- Communicate with providers, patients, coders, or other responsible persons to ensure that claims are correctly processed by third party payers.
- Adhere to general practices and FGP guidelines on compliance issues and patient confidentiality.
- Request coding guidance as needed.
- Review and resolve uncollected accounts and prepare charge corrections.
- Complete monthly action plans.
- Review reports to identify revenue opportunities and unpaid claims.
- Enter account notes using standard formatting.
- Utilize CBO Pathways as guide for determining actions needed to resolve unpaid or incorrectly paid claims.
- Follow workflows provided in training classes and request additional training as needed.
- Identify payer and provider credentialing issues and address them with management.
- Perform daily tasks in assigned work queues and according to manager assignments.
- Developed customized reports for management to monitor key performance indicators in the coding department.
- Improved team productivity, conducting regular training sessions on coding guidelines and updates.
Business Office Associate
NYU Langone Health
01.2015 - Current
- Correctly clear work DAR for Breast Surgeons and Medical Doctors Oncology Department.
- Correctly clear work DAR for Radiology Imaging screening and diagnostic procedures.
- Verify insurance eligibilities and authorizations, obtain referrals, Authorizations for in network and out of network services.
- Collecting copays, co-insurances and deductibles, prior balance owed on patients account.
- Thoroughly research newly identify health insurances coverage plan from NYC Health exchange markets Provide hospital and physician billing financial Assistance application.
- Follow up on claims denial and Remittance process.
- Meticulously identify and rectify inconsistencies, deficiencies and discrepancies in registration and billing record Verify patients' eligibility and claims status with insurance agencies.
- Diligently filing and following up on third party claims.
- Utilizing Epic Estimator software to generate patients estimated bill at the time of services.
- Navigating Health insurance websites and tools for insurance eligibilities, claims and benefit information.
Patient Access Representative
Hospital for Special Surgery
09.2010 - 11.2014
- Patient Access to prescreened patients registration acquired insurance and demographic information.
- Managed a daily schedule of 70 to 100 patients for outpatient treatment for infusion therapy.
- Meet and greet patients and directed patients to appointment areas.
- Accessed patient information through variety of office software applications, maintaining strict confidentiality to remain compliance with HIPAA regulations.
- Checked doctor’s schedules and verified insurances.
- Scheduled and confirmed patient appointments with patients and healthcare professionals.
Admitting Clerk
Greenwich Hospital
09.2001 - 04.2010
- Scheduled and confirmed patients' diagnostic appointments for general hospital.
- Interviewed and registered patients for various hospital inpatient admission and outpatient appointments Collection of copays, deductibles and co-insurance due at time of procedures.
- Coordinated with funeral homes and families for release of the deceased.
- Maintained daily census of hospital beds, patients admitted and patients discharged. Professionally and courteously verified appointment times with patients.
Education
Associate of Science - Health Administration
Norwalk Community College
Norwalk, CTBachelor of Science - Healthcare Administration
University of Arizona Global Campus
Skills
- Medical terminology expert
- Proficient with International Classification of Disease and Current Procedure Terminology
- ICD-10CM, HCPCS and CPT current year guidelines
- Hospital Electronic Medical Record (EMR) on Epic and Microsoft Office
- CMS, and MAC contractor National Government service (NGS) LCD,NCD, PTP and NCCI edits, NGSConnex
Certification
Current AAPC CPC Certified professional coder and CPB Certified Professional Biller and RCM Revenue cycle management certification
Timeline
Billing Coordinator
NYU Langone Hospital System and NYU School of Medicine
05.2021 - Current
Business Office Associate
NYU Langone Health
01.2015 - Current
Patient Access Representative
Hospital for Special Surgery
09.2010 - 11.2014
Admitting Clerk
Greenwich Hospital
09.2001 - 04.2010
Bachelor of Science - Healthcare Administration
University of Arizona Global Campus
Associate of Science - Health Administration
Norwalk Community College
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