Tashayla Ramsey
Tarentum,PA
Summary
Motivated health information professional with a successful track record in the effective management and utilization of health data systems. Proven ability to lead and collaborate with multidisciplinary teams, driving process improvements and fostering a culture of excellence. Committed to upholding confidentiality, ethical standards and delivering high-quality healthcare services through comprehensive health information management.
Overview
15
15
years of professional experience
Work History
Customer Experience Associate I
Magellan Healthcare
Remote
06.2023 - Current
- Provides precertification for inpatient admission, and post service requests.
- Review service requests and manage the requests as efficiently as possible involving the appropriate department as needed.
- Responsible for the identification and data entry of referral requests into the UM system.
- Research claim rejections, make corrections, take corrective actions, and/or refer claims to appropriate colleagues to ensure timely and accurate claim resolution.
- Investigates and examines source of denials utilizing knowledge of ICD-10 coding, CPT coding.
ENGAGEMENT CENTER REP I
Advocate Aurora Health
Remote
02.2023 - 06.2023
- Evaluate medical eligibility by conducting insurance verifications to negotiate payment methods.
- Scheduling patient appointments and coordinating cancellations, reschedules Obtain demographic and insurance information, verify insurance coverage, and may collect co-pays, deductibles, and previous balances.
- Provide referrals to physicians/providers by following senior instructions ensuring information is accurate and correct.
- Identifies emergent calls based on information provided by the caller and department guidelines.
- Submitting medication refill requests for evaluation, and paging providers and facilities as appropriate.
Contact Representative
Internal Revenue Service
Pittsburgh PA
05.2022 - 11.2022
- Resolving the concerns of up to 75 taxpayers daily through investigation, and documentation on both Account Management Services (AMS) and Integrated Data Retrieval System (IDRS)
- Identify problems with tax accounts using a person-centered approach to identify primary concerns such as computation errors, tax adjustments, credit transfers, refunds, and information on master file
- Decrease risk of missed tax credits, deductions, and benefits through a detailed internal review of tax documentation for mistakes in calculations, data entry or procedures
- Minimize time spent on assessing individuals by using critical thinking, and problem-solving skills to determine relevant questions to ask regarding taxable income, deductible expenses, or allowances
- Increase awareness of individuals or third-party representatives on actions taken, tax regulations, or enforcement actions using clear and concise communication
- Managed over 50 taxpayer calls per day applying attention to detail and professionalism providing excellent customer service with 96% satisfaction rate.
Store Manager
Payless Shoe source
Pittsburgh, PA
09.2018 - 03.2019
Store Manager
Just Cozy USA
Pittsburgh, PA
10.2017 - 01.2018
Store Manager/District Recruiter
Avenue Stores
Pittsburgh, PA
06.2009 - 11.2015
Education
Associate of Science - Health Information Systems
University of Cincinnati
11.2025
Career Diploma - Medical Coding Specialist
U.S. Career Institute
01.2023
Skills
- Data Entry and Maintenance
- Administrative and Clerical Procedures
- Efficient and Detail-Oriented
- Documentation Review
- Microsoft Office and G Suite
- Medical Terminology
- HIPPA Guidelines
- Epic
- ICD-10
- CPT-4
- HCPC II
Timeline
Customer Experience Associate I
Magellan Healthcare
06.2023 - Current
ENGAGEMENT CENTER REP I
Advocate Aurora Health
02.2023 - 06.2023
Contact Representative
Internal Revenue Service
05.2022 - 11.2022
Store Manager
Payless Shoe source
09.2018 - 03.2019
Store Manager
Just Cozy USA
10.2017 - 01.2018
Store Manager/District Recruiter
Avenue Stores
06.2009 - 11.2015
Associate of Science - Health Information Systems
University of Cincinnati
Career Diploma - Medical Coding Specialist
U.S. Career Institute
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