Tiarie Barnes
Overview
20
20
years of professional experience
1
1
Certification
Work History
Revenue Director
Surgical Associates
Current
- I oversee the billing staff to ensure adequate billing is submitted accurately
- I manage my team, who works diligently by making sure claims are coded and scrubbed prior to submission
- My team is in charge of the following: verifying insurance, contact adjusters regarding all work comp claims, submit appeals and handle peer to peer when necessary, also submit Pre-determinations
- I also oversee the A/R, Implement, webinars, Tutorials for the billing department, update all providers licenses via CAQH, comply with MIPS/MACRA
- I review staff reports on call volume from inbound calls from patients and outbound calls to insurance payers
- My team enters their daily claims tracker via excel, which gives me a clears optics of what my staff is working on daily and KPI’S to manage my staff’s productivity
- Analytical reports are reviewed, and I review reports that allow me to review billing trends such as denials and rejections
- I have compiled all my data into a report to the leadership team for a weekly update
- I also conduct weekly team meetings to discuss wins for the week or concerns they may need to address
Revenue Billing Manager
Spine Center of Illinois
01.2006 - 01.2014
- Manage/Lead the medical billing department
- My team works on the entry of superbills and Surgery Charges, SNF, post payment payments, submit patient charges to insurance companies, verify insurance, initiate surgery prior authorization, send out monthly statements, correct rejected claims that were submitted, appeal claim denial, work Aging report, collecting, and submit secondary insurance with attached EOB
- Properly vet all incoming work comp cases, verify work comp insurance claim, contact adjusters
- Update physician’s licenses and all other pertinent information in CAQH database
- I manage all staff workflow and review all reports which provide me with my team’s productivity
- I provide training when needed within the team
Team Lead Workers Comp Adjuster/Medical Analyst
Humana Insurance
01.1994 - 01.2006
- Review claimants date of injury reports, issue claim cases for claimants, schedule medical exams to verify work injury, request medical records, issue lost time wages, process and pay medical claims, review appeals, set up follow up exam, run monthly financial reports
Education
bachelor’s degree - Business Administration, CCS, RHIT, AAPC, COC, CIC
University of Wisconsin Madison
01.1995
Skills
- Team building
- Policies Procedures
- Problem solving
- Accounts Payable Receivable
- Rapid Claims Process
- Coding, CPT, ICD-10
- Medical knowledge & Terminology
- Customer Service
- Employee morale
- Motivation
- Data-driven decision making
- Microsoft Excel proficiency
- Budgeting and planning
- Audit coordination
- Account reconciliation
Certification
- CCS
- RHIT
- AAPC
- COC
- CIC
Timeline
Revenue Director
Surgical Associates
Current
Revenue Billing Manager
Spine Center of Illinois
01.2006 - 01.2014
Team Lead Workers Comp Adjuster/Medical Analyst
Humana Insurance
01.1994 - 01.2006
bachelor’s degree - Business Administration, CCS, RHIT, AAPC, COC, CIC
University of Wisconsin Madison
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