Tanya Maxwell
Sun City,CA
Summary
Motivated medical associate with solid experience managing all levels of large scale medical issues, including budgeting authorizations, insurance denials/appeals, medical billing and administration. Patient-focused medical Representative/associate with 13+ years of providing solutions to patients, insurance companies and federal agencies. Solid understanding and experience in all aspects of the medical field. Self-motivated Strong verbal communication Conflict resolution Powerful negotiator Client assessment and analysis Extremely organized Team leadership Process implementation Data management Positive attitude
Overview
18
18
years of professional experience
Work History
Surgery Scheduling Coordinator
Orthopaedic Surgery And Sports Medicine
Temecula, CA
05.2021 - Current
- Coordinated with facilities to set up surgeries for 3 orthopedic surgeons.
- Verified insurance coverage and obtained pre-authorizations.
- Expertly managed planning, scheduling and coordination of outpatient procedures.
- Educated patients about surgeries and provided treatment plan documentation.
- Reviewed medical histories and current information to provide accurate information to surgeons.
- Received, recorded and addressed incoming and outgoing communication via telephone and email.
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
- Contacted hospitals to confirm patients medical histories and prevent inaccurate diagnoses and treatments.
Medical assistant/Spine surgery scheduler/Medical biller
Girard Orthopaedic Surgeons Medical Group, Inc
San Diego, CA
06.2004 - 04.2021
- Achieved revenue and medical billing issues by obtaining proper medical necessity approval, researching and submitting all denial appeals
- Schedule and prepare patients for spine surgery preoperatively and postoperatively
- Researched and updated all required materials needed for surgeons and patients
- Submit all claims and denials for insurance companies/Workers Compensation agencies
- Performed initial patient assessment and analysis to begin medical authorization process
- Ensure payment/billing for orthopedic surgeons
- Supported busy spine surgeon with daily operational functions
- Assist patients with federal, state and local disability claims and documents
- Analyzed medical documents for appropriate distribution, medical billing and authorizations for patients.
- Sanitized, restocked and organized exam rooms and medical equipment.
- Obtained client medical history, medication information, symptoms and allergies.
- Directed patients to exam rooms, fielded questions and prepared for physician examinations.
- Collected and documented patient medical information such as blood pressure and weight.
- Performed clerical duties, such as word processing, data entry, answering phones and filing.
- Documented vital signs and health history for patients in clinic and hospital environments.
- Called and faxed pharmacies to submit prescriptions and refills.
- Scheduled appointments, registered patients.
- Taught patients about medications, procedures and care plan instructions.
- Completed clinical procedures and gathered patient data for interpretation by physician.
- Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment.
- Obtained pre- and post-treatment vital signs and weight.
- Promoted office efficiency, coordinating charts, completing insurance forms and helping patients with diverse needs.
- Arranged surgeries with surgical center, confirming times with patients and preparing admission and consent forms.
- Compiled necessary documents for surgical billing packages.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
- Verified signatures and checked medical charts for accuracy and completion.
- Reviewed patient charts to better understand health histories, diagnoses and treatments.
- Scanned and filed medical records in alphabetical order to maintain organized and up-to-date filing system.
- Utilized active listening, interpersonal and telephone etiquette skills when communicating with others.
- Guarded against fraud and abuse by verifying coded data accurately reflected services provided.
- Resourcefully used various coding books, procedure manuals and on-line encoders.
- Accurately selected proper descriptive code when more than one anatomical location was indicated.
- Entered orders into EMR system efficiently and without errors.
- Used Centricity and Epic System to input information into computerized patient record system.
- Applied charges and updated patient records by using Epic billing system and EMR software.
Education
Medical Billing And Coding Specialist - Medical Billing And Coding
Eastern Gateway Community College
Steubenville, OH05.2022
Medical Assisting, Phlebotomy, Healthcare Admin - Healthcare
California Medical College
San Diego, CA2010
Pharmacy Technician - Healthcare
United Education Institute
San Diego, CA2002
High School Diploma -
San Diego School of Creative And Performing Arts
San Diego, Ca06.1997
Skills
- Medical Report Preparation
- Taking Client Histories
- Advising Patents
- Patient History Collection
- Reviewing Medical Histories
- Exceptional Attention to Detail
- Tracking Systems
- Online Systems
- Treatment Documentation
- Organization and Time Management
- Orthopedic Surgery
Timeline
Surgery Scheduling Coordinator
Orthopaedic Surgery And Sports Medicine
05.2021 - Current
Medical assistant/Spine surgery scheduler/Medical biller
Girard Orthopaedic Surgeons Medical Group, Inc
06.2004 - 04.2021
Medical Billing And Coding Specialist - Medical Billing And Coding
Eastern Gateway Community College
Medical Assisting, Phlebotomy, Healthcare Admin - Healthcare
California Medical College
Pharmacy Technician - Healthcare
United Education Institute
High School Diploma -
San Diego School of Creative And Performing Arts