TARNESHA J. MCRAE
Safford,TX
Summary
To obtain a career that will allow me to utilize my qualifications and skills, with 25 years of Physician Medical Billing, and Collections experience.
Overview
21
21
years of professional experience
Work History
Medical Collection Specialist III
FMA ALLIANCE
03.2024 - Current
- Duties: insurance follow-up, claims, ub04, appeals, high dollar special projects, adjustment, underpayments, correspondence, adjustment, electronic billing, refunds, post payments, Modifiers, team projects, HCFA claims, aging claims, delinquent accounts, ATB reports, mailed patient statements, answer patient or incoming insurance calls, met daily productivity, modifiers, aging claims, delinquent accounts, verify patient insurance, update patient demographics as needed. other assigned duties.
Medical records bookmarker/BILLING
VES/Maximus HealthCare
10.2019 - 02.2024
- Duties: work under immediate supervisor to maintain files for medical treatment for patients, perform complex record keeping including compiling data, proofreading, retrieval of reports and forms, maintenance of computerized records to send to physicians for review, ENTER daily charges, balance batch daily, checked clearing house for edits
Physician billing and collection
Tyvan Medical Billing and Coding
06.2017 - 01.2020
- Duties: Follow up on self pay, insurance accounts, collections on bad debt or under paid accounts. Verify insurance, correct patient data, Correspondence, electronic billing, refunds, post payments, Modifiers, team projects, HCFA claims, aging claims, delinquent accounts, ATB reports, mailed patient statements, answer patient or incoming insurance calls, met daily productivity.
Payment Poster, Insurance follow-up
Texas Oncology Cancer Center
06.2016 - 05.2017
- Duties: post payments to accounts, process billing statements, conducting audits, balance batches and run transaction reports daily, assess EOB from insurance companies, keep track of payments deposits from patients and insurance. Date entry, accurate billing and reported and discrepancies to accounting, adjustments, refunds. Overpayment reports. aging claims, delinquent accounts, ATB reports, mailed patient statements, answer patient or incoming insurance calls, met daily productivity, collections on bad debt or under paid accounts. Verify insurance, correct patient data
Reimbursement Specialist
Behavioral Hospital of Bellaire
03.2015 - 05.2016
- Duties: Insurance follow-up, ensure the patient insurance covers their treatment. Review the appropriateness of CPT/ICD-9 coding and determine if care provided corresponds to charges submitted. Perform varies task as delegated for special projects. Worked closely with physicians and clinical staff for accuracy of billing information for claims. Helping patients with processing of their insurance claims. Pre-certs, correspondence, appeals, erroneous claims, UB-92, HCFA 1500, denial resolution, Check Emdeon Clearinghouse for edits correct and resubmit.
Patient Financial Specialist
Obstetrical & Gynecological Associates
05.2007 - 11.2014
- Duties: Medical billing and coding for OB, collect surgery and OB deposits, collections on bad debt, post payments, update patient demographics, follow up on claims, appeals, refunds, view EOB, verify benefits, worked credit balance reports, secondary billing, contractual adjustments, correct erroneous claims, team projects, follow-up on AR aging claims, correspondence, delinquent accounts, ATB reports, patient statements, patient statements, modifiers.
Reimbursement Team Lead
Per-se Technologies
06.2004 - 04.2007
- Duties: Audit accounts, monitor productivity, Edi reports, timecards, assist with recruiting/interviews, training. In charge of NICU/OB/Anesthesia claims follow-up, correct any discrepancies on claims and resubmit corrected claim to carrier for payment resolution, contractual adjustments, statement letter to patients, work edits verify benefits, update or corrected patient demographics, electronic claim submission, appeals, secondary and third part billing, generated reports, worked underpaid special accounts, process paper and electronic claims answer calls regarding insurance, worked aging reports, other duties as assigned.
Education
No Degree - medical coding and billing course
DHS
Houston, TX08.2013
No Degree - Nursing
HOUSTON, COMMUNITY COLLEGE
Houston, TX01-1996
High School Diploma -
Willowridge
Houston, TX06-1991
Skills
- Mysis, Visions, Medisoft, IDX, PCS-bar, TDH connect, Citrix, Radnet, Navinet, ECW-eclinical works, MS4, Midas, Ace, Epic, Sovera, Healthquest
- Teamwork orientation
- Account review
- Relationship building
- Collections
- Proficiency in [software] ACE, EPIC, HEALTH QUEST, SOVERA
- Customer research
- Conflict resolution techniques
- Goal-oriented mindset
- Data entry efficiency
- Decision-making
- Outbound calling
- Issue investigation
- Empathy and tactfulness
- Account reconciliation
- Financial statements expertise
- Finance
- Records management
- Payment acceptance
- Bookkeeping
- Goals and performance
- Active listening
- Insurance policies
- Payment plan management
- Performance improvement techniques
- Billing problem resolution
- Balance collection
- Billing practices
- Analytical and critical thinking
- Attention to detail
- Microsoft office
- Aging reports analysis
- Clear communication
- Payment scheduling
- Codes reviewing
- Updating customer accounts
- Delinquent account notification
- Problem identification
- Investigative research
- Pleasant telephone demeanor
- Basic mathematics
- Negotiation and resolution
- Insurance company communication
- Word processing
- Organizational skills
- Accurate payment posting
- Social perception
- Conflict resolution
- Debt repayment negotiation
- Payment processing
Timeline
Medical Collection Specialist III
FMA ALLIANCE
03.2024 - Current
Medical records bookmarker/BILLING
VES/Maximus HealthCare
10.2019 - 02.2024
Physician billing and collection
Tyvan Medical Billing and Coding
06.2017 - 01.2020
Payment Poster, Insurance follow-up
Texas Oncology Cancer Center
06.2016 - 05.2017
Reimbursement Specialist
Behavioral Hospital of Bellaire
03.2015 - 05.2016
Patient Financial Specialist
Obstetrical & Gynecological Associates
05.2007 - 11.2014
Reimbursement Team Lead
Per-se Technologies
06.2004 - 04.2007
No Degree - medical coding and billing course
DHS
No Degree - Nursing
HOUSTON, COMMUNITY COLLEGE
High School Diploma -
Willowridge
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