Tara Lonardo
Cranston,RI
Summary
Dynamic professional with extensive experience in claims processing and provider communication at Neighborhood Health Plan of Rhode Island. Proven track record in enhancing billing accuracy and resolving issues efficiently. Skilled in data analysis and committed to HIPAA compliance, demonstrating strong problem-solving abilities and attention to detail in fast-paced environments.
Experienced with managing provider relations and addressing inquiries effectively. Utilizes communication and problem-solving skills to ensure seamless interactions between providers and healthcare organizations. Track record of enhancing provider satisfaction and operational efficiency through strategic initiatives.
Thorough team contributor with strong organizational capabilities. Experienced in handling numerous projects at once while ensuring accuracy. Effective at prioritizing tasks and meeting deadlines.
Overview
24
24
years of professional experience
Work History
Provider Services Rep Level 3 / Claims Adjuster
Neighborhood Health Plan of Rhode Island
08.2021 - 09.2024
- Facilitated communication between providers and plan members to enhance service delivery.
- Managed provider inquiries, ensuring accurate and timely resolutions of issues.
- Coordinated training sessions for new providers on plan policies and procedures.
- Analyzed provider feedback to identify areas for process improvement.
- Coordinated with internal departments on behalf of providers to ensure timely payment resolution for claims disputes or other financial matters.
Emergency Road Service Dispatcher
AAA Northeast
12.2018 - 03.2021
- Coordinated emergency service requests, ensuring prompt response and efficient resource allocation.
- Monitored real-time traffic conditions using GPS tools to optimize route planning for service vehicles.
- Evaluated dispatcher performance metrics, implementing strategies to enhance operational efficiency and service quality.
- Trained new dispatchers on system protocols, fostering a collaborative team environment and knowledge sharing.
- Developed and maintained relationships with local towing services, enhancing partnership effectiveness and responsiveness.
- Contributed to the overall success and reputation of the Emergency Road Service team by consistently demonstrating exceptional dispatching skills and outstanding customer support.
Medical Biller and Coder
Alpha Physical Therapy
02.2015 - 11.2018
- Managed patient billing processes ensuring accurate coding and timely submission of claims.
- Implemented quality control measures to enhance accuracy in medical coding and reduce claim denials.
- Trained junior staff on coding guidelines and billing procedures to improve team performance and compliance.
- Collaborated with healthcare providers to resolve billing discrepancies and optimize revenue cycle management.
- Reduced claim denials through meticulous verification of patient eligibility and coverage benefits prior to claim submission.
- Worked closely with physicians to accurately assign ICD-10 diagnostic codes for optimal reimbursement rates from insurance companies.
- Correctly coded and billed medical claims for various hospital and nursing facilities.
Medicare Part D Intake Coordinator
CVS Caremark
03.2011 - 01.2015
- Coordinated patient intake processes to ensure timely service delivery and enhanced patient experience.
- Managed scheduling for patient appointments, optimizing resource allocation and workflow efficiency.
- Executed data entry tasks with precision, maintaining accurate electronic health records for compliance and reporting.
- Trained new staff on intake procedures, fostering a collaborative team environment and improving overall performance.
- Led initiatives to streamline communication between healthcare providers and patients, reducing wait times and improving satisfaction scores.
- Maintained strict confidentiality of patient information, adhering to HIPAA guidelines and company policies.
Medical Billing Analyst
New England Ambulance
03.2007 - 01.2011
- Analyzed medical billing data to ensure compliance with regulations and accuracy in claims processing.
- Managed accounts receivable, resolving discrepancies to enhance revenue cycle efficiency.
- Developed and implemented billing procedures to streamline operations and reduce errors.
- Collaborated with healthcare providers to clarify billing codes and improve claim submissions.
- Facilitated communication between departments to address billing inquiries and enhance customer satisfaction.
- Identified areas for improvement in billing practices, providing recommendations that led to increased efficiency and cost savings.
- Streamlined billing procedures by implementing effective coding systems and ensuring compliance with regulatory requirements.
Medical Biller, Accounts Receivable
Blue Cross of Rhode Island
09.2000 - 01.2007
- Managed claim submissions, ensuring compliance with industry regulations and internal policies.
- Reviewed accounts receivable reports to identify discrepancies and resolve billing issues effectively.
- Collaborated with healthcare providers to obtain necessary documentation for claims processing.
- Developed streamlined processes for tracking unpaid claims, enhancing follow-up efficiency.
- Organized and filed all necessary documentation related to medical billing procedures, maintaining a streamlined office environment conducive to efficient operations.
- Implemented quality assurance measures to minimize errors in data entry, leading to increased claim approval rates from insurers.
Education
Medical Billing & Coding - Medical Billing & Coding
NUC
High School Diploma -
Cranston High School West
Cranston, RI06-1995
Vocational School - Marketing & Distributive Education
Cranston Area Career & Technical Center
Cranston, RI06-1995
Skills
- Claims processing
- Provider communication
- Customer service
- Issue resolution
- Billing accuracy
- Data analysis
- Revenue cycle management
- HIPAA compliance
- Medical coding standards
- Call center experience
- Insurance verification
- Data entry proficiency
- Healthcare industry
- Provider relations
- Problem-solving skills
- Attention to detail
- Multitasking
Timeline
Provider Services Rep Level 3 / Claims Adjuster
Neighborhood Health Plan of Rhode Island
08.2021 - 09.2024
Emergency Road Service Dispatcher
AAA Northeast
12.2018 - 03.2021
Medical Biller and Coder
Alpha Physical Therapy
02.2015 - 11.2018
Medicare Part D Intake Coordinator
CVS Caremark
03.2011 - 01.2015
Medical Billing Analyst
New England Ambulance
03.2007 - 01.2011
Medical Biller, Accounts Receivable
Blue Cross of Rhode Island
09.2000 - 01.2007
Medical Billing & Coding - Medical Billing & Coding
NUC
High School Diploma -
Cranston High School West
Vocational School - Marketing & Distributive Education
Cranston Area Career & Technical Center