Tawana Frazier
Durham,NC
Summary
Highly enthusiastic office professional with 30 year’s client interface experience. Customer focused with a solid understanding of the dynamics of Medicare, Medicaid, commercial and private insurance, and motivated to maintaining customer satisfaction and contribute to the success of any organization. Extensive knowledge of medical billing with an emphasis on excellent customer service makes a vital candidate for any organization. Goal-oriented with forward-thinking and resilient mindset. Accurate, and detail-oriented in handling monies. Bringing [30] years of experience working to help clients reach financial stability.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Financial Care Counselor
Duke Home Care And Hospice
Durham, NC
09.2019 - 11.2021
- Data Entry of Authorizations and Written Requests. Managed over seventy-five calls per day.
- Review and validate supporting documentation provided by patients, and attorney.
- To ensure that they meet both State and Federal guidelines (i.e., Power of Attorney Executor Papers, Death Certificate, Guardianship Papers) Enters request into Maestro Care ROI electronic work- flow
- Utilized knowledge of HIPAA, NC Statue and DUHS policies pertinent to release of information
- Positions at this level have high customer service, strong analytic and problem-solving skills, require interpretation and explanation of policy and internal requirements related to health record documentation and completion, Medical Staff Bylaws, Rules and Regulations and organization-wide functions and policies and procedures
- Document Management Functions: Maintains integrity of Clinical Data Repository (CDR) with super user knowledge and general understanding of workflows between patient software applications.
Patient Account Specialist
UNC / Rex
Chapel Hill, NC
01.2017 - 08.2019
- Reimbursements and Overpayments
- Responsible for accurate and timely complaint preparation submission, follow-up and wad of bills, statements and claims to third party payor organizations
- Process overpayments and credits to insurance companies and patients within a timely manner
- Significant knowledge of office or work unit procedures, methods, and practices
- Data entry skills and working with databases
- Significant knowledge of and ability to use correct grammar, vocabulary, and office terminology to compose and/or proofread. correspondence, reports, and other materials
- Ability to apply sentence and grammatical structure to independently compose and format materials within established guidelines
- Ability to record, compile, summarize, and perform basic analysis of narrative and numerical materials
- Ability to learn and independently apply laws, departmental rules, and regulations
- Ability to learn office process and procedures and apply this knowledge in problem-solving and responding to questions and inquiries
- Ability to use judgment in coordinating and monitoring office procedures and workflow
- Ability to use courtesy and tact in performing public contact and communication duties that may be sensitive in nature.
- Posted payments and processed refunds.
- Responded to patient, family, and external payer inquiries.
Staff Assistant
Duke Cancer Institute
Durham, NC
03.2015 - 06.2016
- Prepare acknowledgments for Duke Cancer Institute memorial and honoring gifts by accurately entering data into Access and merging appropriate templates for these gifts
- Update templates as appropriate
- Provide reports within a timely manner to families of donors who have contributed a gift in a loved one's name
- Respond to donor questions/concerns regarding these gifts
- Enter donor data into online Convio system for event related gifts so that accurate reporting may be maintained for event and team totals
- Respond to donor questions/concerns regarding gifts logged into this system
- During peak times of the fiscal year, provide support for the initial processing of gifts following audit guidelines
- Maintain internal mailing lists for non-donor constituency
- Liaise with Alumni and Development Affairs concerning biographical input and gift data
- Assist in reconciling gifts received in the DCI Development office and their entry into the SAP/R3 system
- Plan and schedule work priorities in accordance with current departmental activities and deadlines
- Advise supervisor on the status of current activities, additional or expanded program requirements and appropriate recommendations for solution to problems
- Cross train with the other departmental staff specialist level 8 to achieve above objectives
- Perform other related duties incidental to the work described herein.
- Maintained professional front desk, handled incoming calls and delivered exceptional service to every guest.
- Delivered clerical support by handling range of routine and special requirements.
- Interacted with customers by phone, email or in-person to provide information.
- Provided expert administrative support to meet daily requirements and maximize team productivity.
- Prepared meeting materials and took clear notes to distribute to stakeholders.
- Collaborated cross-functionally to efficiently meet project demands and accomplish schedule targets.
- Produced high-quality documents, spreadsheets and presentations for internal and customer-facing needs.
- Upheld strict visitor security protocols for office staff effectively protecting assets and personnel from unauthorized visitors.
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Delivered top-notch administrative support to office staff, promoting excellence in office operations.
- Worked closely with manager to provide effective assistance for specific aspects of business operation.
Patient Account Associate
Duke University Patient Revenue Management
Durham, NC
07.2010 - 06.2012
- Created spreadsheets using Microsoft Excel for daily,
- Worked to maintain outstanding attendance record, consistently arriving to work ready to start immediately
- Created plans and communicated deadlines to complete projects on time
- Developed and implemented performance improvement strategies and plans to promote continuous improvement
- Actively listened to customers, handled concerns quickly and escalated issues to supervisor
- Worked within applicable standards, policies, and regulatory guidelines to promote safe working environment
- Developed and maintained courteous and effective working relationships
Patient Account Associate
Duke University Patient Revenue Management
Durham, NC
02.2009 - 07.2010
- PRMO
- Government Collections
- File claims to commercial and private insurance companies and to follow up with insurance companies, Data entry, Telephone Protocol, CRT, Accounting, Billing and Collections, and Correspondence
- Research and analysis third party claims: verifies coverage and resubmits claims as needed
- Utilizes Internet Access: Online Access for claims review and identifies and investigates problem delinquencies through prompt follow up efforts to third party payer recommends appropriate disposition for reimbursement
- Knowledge of coding due to many changes in APC/DRG rates.
- Responds by telephone or correspondence to inquire from third party payers, understands medical insurance, researches problems, and corrects errors, interprets remittance documents from all third-party payers to ensure accurate postings
- Maintain statistical data and records: Prepare regular scheduled reports on productivity and medical claims.
- Answered customer emails, and telephone calls to respond to questions, provide details and resolve concerns.
- Effectively secured and negotiated contracts with high-value clients in collaboration with patient accounts.
- Deployed meticulous organization skills by assisting in coordination of client deliverables.
- Sharpened skills by obtaining required continuing education credits and attending training to keep updated on legislative and industry changes.
- Set up, updated and closed customer accounts in computer system.
- Reconciled account information and reported figures in general ledger by comparing to bank account statement each month.
- Maintained account accuracy by reviewing and reconciling checks monthly.
- Generated invoices upon receipt of billing information and tracked collection progress.
- Reconciled accounts, updated financial records with remarkable accuracy.
- Effectively communicated with clients about payment needs and kept updated, detailed and accurate ledgers.
Patient Account Associate
Duke University
Durham, NC
07.1995 - 02.2009
- Managed heavy inbound call volume of over five hundred calls a week.
- Answer and resolve all inbound inquiries and issues regarding patient account statements
- Analyze patient's problem or issue that is presented by collecting information and data and conducting thorough research of patient accounting systems,
Education
Associate of Applied Science - Medical Insurance Billing
Stratford Career Institute
Mount Laurel, CA05.2013
Associate of Applied Science - Business Administration And Management
Stratford Career Institute
Ontario, CA05.2013
Certificate of Higher Education Coursework in Business, Marketing And Communications. Related Coursework in Microsoft Office - Business Administration & Office Systems Technology
Barclay Career School
East Orange, NJ05.1991
Skills
Telecommunication
- Forms and Spreadsheet Creation
- Payment Calculation
- Efficient Service
- Reliability and Dedication
- Word Processing
- Claims Handling and Coverage Verification
- Forms and Spreadsheet Creation
- Payment Calculation
Accomplishments
- The Billing Specialist and Health Insurance
- The Qualifications of the Billing Specialist
- Legal Aspects of Insurance Billing
- Health Insurance Terminology
- Paying with Health Insurance
- International Classification of Diseases
- Clinical Modification
- ICD-9-CM Components
- Diagnostic Codes
- Miscellaneous Coding Guidelines
- The ICD-10-CM
- Procedural Terminology, Insurance Claims, and Managed Care
- Current Procedural Terminology (CPT)
- CPT Coding Format Conventions
- Health Care Financing Administration
- Procedure Coding System
- Using the HCPCS System
- HCPCS Level II and Level III
- Developing an Insurance Claim
- Health Care Financing Administration (HCFA) Guidelines
- HCFA – 1500: Completion Guidelines
- Electronic Claims
- Managed Care Organizations
- Types of Insurance Coverage Plans
- Blue Cross / Blue Shield Plans
- Medicare Health Plan
- Medicaid Coverage and Billing
- Tricare Billing
- CHAMPVA Claims
- Fraud and Abuse
- Workers' Compensation
Certification
- [Area of certification] Training -Billing and Collections certification
Timeline
Financial Care Counselor
Duke Home Care And Hospice
09.2019 - 11.2021
Patient Account Specialist
UNC / Rex
01.2017 - 08.2019
Staff Assistant
Duke Cancer Institute
03.2015 - 06.2016
Patient Account Associate
Duke University Patient Revenue Management
07.2010 - 06.2012
Patient Account Associate
Duke University Patient Revenue Management
02.2009 - 07.2010
Patient Account Associate
Duke University
07.1995 - 02.2009
Associate of Applied Science - Medical Insurance Billing
Stratford Career Institute
Associate of Applied Science - Business Administration And Management
Stratford Career Institute
Certificate of Higher Education Coursework in Business, Marketing And Communications. Related Coursework in Microsoft Office - Business Administration & Office Systems Technology
Barclay Career School
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