Summary
Overview
Work History
Education
Skills
Timeline
Generic

Tiara McDowell

Atlanta,Georgia

Summary

Organized and detail-oriented Investigator dedicated to improving efficiency, productivity and profitability through continuous process improvement. Analytical thinker skilled at developing innovative solutions to complex problems.

Overview

8
8
years of professional experience

Work History

Claims Adjuster

EA Renfroe
05.2019 - 10.2023
  • Examined claims forms and other records to determine insurance coverage.
  • Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
  • Prepared summaries of damage, payments, and policy coverage.
  • Researched and analyzed policy contracts to verify proper payment of claims.
  • Evaluated insurance policies and analyzed damages to determine coverage.
  • Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
  • Established relationships with clients and insurance companies to foster timely claims resolution.
  • Mitigated risks and increased profitability with well-developed strategies for reducing future claims and costs.
  • Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
  • Analyzed information gathered by investigation and report findings and recommendations.

Patient Access Representative

Piedmont Hospital
03.2016 - 05.2019
  • Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
  • Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
  • Stayed calm under pressure to and successfully dealt with difficult situations.
  • Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
  • Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
  • Performed patient scheduling and registration functions to serve as initial contact point for medical office visits.
  • Coordinated patient's care by facilitating caregiver access to medical home providers and resources to meet patient needs.
  • Verified patient insurance eligibility and entered patient information into system.
  • Processed payments using cash and credit cards, maintaining accurate records of transactions.
  • Answered incoming calls, scheduled appointments and filed medical records.
  • Compiled and maintained patient medical records to keep information complete and up-to-date.
  • Applied administrative knowledge and courtesy to explain procedures and services to patients.

Education

No Degree - Medical Billing And Coding

Institute of Ultrasound Diagnostics
Dunwoody, GA
05.2003

High School Diploma -

Fredick Douglas High School
Atlanta, GA
05.2000

Skills

  • Medical Terminology
  • Claims File Management Processes
  • Database Management
  • Report Writing
  • Risk Management
  • Data Analysis
  • Microsoft Word
  • Critical Thinking
  • Complex Problem-Solving
  • Healthcare Common Procedure Coding System (HCPCS)

Timeline

Claims Adjuster

EA Renfroe
05.2019 - 10.2023

Patient Access Representative

Piedmont Hospital
03.2016 - 05.2019

No Degree - Medical Billing And Coding

Institute of Ultrasound Diagnostics

High School Diploma -

Fredick Douglas High School

Similar Profiles

CREATE PROFILE
Tiara McDowell