Tara Wash
Rosharon,Texas
Summary
Dynamic Senior Insurance Verifier with extensive experience at Houston Methodist Hospital System, excelling in insurance verification and authorization processing. Proven track record in claims management and patient estimation, fostering strong relationships with patients and payors. Adept at training staff and resolving complex issues, ensuring efficient operations and exceptional service delivery.
Overview
17
17
years of professional experience
Work History
Senior Insurance verifier
Houston Methodist Hospital System
Houston, TX
07.2018 - Current
- I currently work on 40 accounts and oversee auth follow up and auth pre-cert team members accounts.
- Verify various insurance and document estimated amount owe for up front collections.
- Obtain authorizations for diagnostic high-tech radiology outpatient services and coordinate the efficient flow of information between patients, the medical staff, and third-party requestors.
- Providing clinical information to payors and case management to help resolve issues with certifications and serves as a resource to management, including training and providing excellent customer service to patients, clinical personnel, and doctors.
- Work closely with the scheduling department providing updates on accounts for any delays with authorization and if there need to be any reschedules.
Sr Patient Affairs Coordinator
Houston Methodist Hospital System
Houston, TX
12.2015 - 07.2018
- Insurance verification for all insurance plans and provided patient's estimations amount owe for inpatient and outpatient services and trained new staff and work to help resolve claim denials.
- Pre-authorizations providing clinical information to payors case management and updating patient's demographic information for correct claim submission and was a lead contact person for any outpatient surgical problems that needed to be resolved.
Prebill Denial Analyst
Parallon Business Solutions System
Houston, TX
07.2015 - 12.2015
- Reviewed post-discharge prebill accounts that do not have an authorization on file and communicated with third-party payors to resolve discrepancies before billing.
- Escalate medical review requests and or denial activities to the Prebill Denial Nurse for resolutions and document all action taken on the accounts in accordance with policies and procedures.
Clinical Appeals Representative
Parallon Business Solutions Systems
Houston, TX
08.2014 - 07.2015
- Monitor insurance claims by running appropriate reports and contacting insurance companies to resolve claims that are not paid promptly on time and identifying coding or billing problems from EOBs to correct the errors promptly on time.
- Worked with patients and guarantors to secure payments on outstanding account balances and informing them about available resources handled through the financial department to help resolve payment issues.
Transfer Coordinator
Houston Methodist Hospital System
Houston, TX
09.2013 - 08.2014
- Booked medical information for all patients transferring to TMH or out to another facility and registered transferring patient with complete and accurate registration data.
- Referred all patients requiring utilization review clearance to a pre-screening Nurse before transfer approval and provided deposit information to the transferring hospital and or patient and to the receiving physician's office before the transfer took place.
Insurance verifier
Methodist Hospital System
Houston, TX
11.2011 - 09.2013
- Verified various medical insurances, commercial, Medicaid, Medicare, Medicare Replacement plans, Governmental and provide a point of service estimations for all inpatient and outpatient surgical procedures.
- Corrected all incorrect insurance plan codes for billing purposes and trained new hired staff to provide excellent customer service while abiding by Houston Methodist System ICARE Values.
Patient Access Representative
Houston Methodist Hospital System
Houston, TX
07.2008 - 11.2011
- Booking patients for inpatient and outpatient procedures.
- Registration, collections for upfront payments, insurance verification.
- Front desk information receptionist, interaction with bed control for patient room assignment.
- Collecting signatures for Medicare and Non - Medicare forms.
- In putting Physician orders; interaction with doctor's offices.
- Help to train and mentor new staff.
Education
Master of Science - Psychology
The University of Phoenix
Phoenix, Arizona05.2020
Bachelor of Science - Psychology
The University of Phoenix
Phoenix, Arizona08.2017
Associate of Arts - Health Care Administration
The University of Phoenix
Phoenix, Arizona09.2012
Skills
- Insurance verification
- Authorization processing
- Medical coding
- Claims management
- Patient estimation
- Customer relationship management
Affiliations
Founder, Taking Our Son's Back, Non-profit outreach ministry program for at risk young men.
Accomplishments
Houston Methodist Health Care System Leadership program completed, 07/01/24
Houston Methodist Health Care System Employee Exceptional Bonus program, 03/19/25 Methodist executive team recognizes that your job performance this past year was exceptional. Your outstanding work has made a difference in our patients' and employees' lives. Your focus on offering patients unparalleled safety, quality,
service and innovation has led to our success this past year.
Timeline
Senior Insurance verifier
Houston Methodist Hospital System
07.2018 - Current
Sr Patient Affairs Coordinator
Houston Methodist Hospital System
12.2015 - 07.2018
Prebill Denial Analyst
Parallon Business Solutions System
07.2015 - 12.2015
Clinical Appeals Representative
Parallon Business Solutions Systems
08.2014 - 07.2015
Transfer Coordinator
Houston Methodist Hospital System
09.2013 - 08.2014
Insurance verifier
Methodist Hospital System
11.2011 - 09.2013
Patient Access Representative
Houston Methodist Hospital System
07.2008 - 11.2011
Master of Science - Psychology
The University of Phoenix
Bachelor of Science - Psychology
The University of Phoenix
Associate of Arts - Health Care Administration
The University of Phoenix
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