TIESHA MATHIS
Pflugerville
Summary
Hardworking Prior Authorization Specialist with successful background working closely with insurance company representatives to gain preapproval for procedures and testing. Detail-oriented performer with over 12 years of managing documentation. Considered team player with exemplary multitasking skills.
Overview
18
18
years of professional experience
Work History
Insurance Authorization Specialist
Texas Oncology
02.2020 - Current
- Researched denied claims and contacted insurance companies to resolve these issues.
- Fielded telephone inquiries on authorization details from plan members and medical staff.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
Patient Services Specialist
Baylor Scott & White Hospital System
11.2019 - Current
- Interviews patients to obtain demographic and insurance information necessary for medical record identification and bill processing. Inputs patient registration information into the computer registration system and verifies accuracy of information. Provides accurate patient, medical, financial, or procedural information to patients. Discusses financial arrangements and issues with patients and/or family members. Verify insurance and review coverage to determine amount due. Prepares required forms orders and maintains inventory of supplies as required
Pre-Authorization/Patient Services Specialist
Capitol Pain Institute
07.2016 - 08.2019
- Verified insurance for procedures, obtained pre-certs/pre-auths, provider patients with cost estimates, approved payment plans, provided customer care, data entry, 10 key, general office duties, multi lines phone and responded to correspondence from insurance companies. Worked closely with all major commercial insurance carries as well as Medicare, TriWest, Tricare, LOP’s and Workers Compensations carriers.
Receptionist/Patient Accounts
Pain Specialist of Austin
03.2014 - 01.2016
- Scheduled appointments, registered patients and verified patient’s appointment times. Multi-line phone system, insurance verification and claim status. Provided customer service and follow up to patient inquiries in a promptly manner. Worked closely to providers and staff to maintain policies, procedures and regulations. Provided costing and balance, updated patient’s accounts, ran aging reports and worked overdue spreadsheets.
Patient Service Representative
Austin Area OBGYN
01.2012 - 03.2014
- Scheduled and registered new patients and distributed sample pharmaceuticals as prescribed. Verified appointments. Managed a multi-line phone system and provided customer service. Prepared patient charts, pre-admissions and consent forms as necessary. Maintained strict patient and physician confidentiality.
Release of Information
Health Port Technologies
11.2010 - 01.2012
- Released information for medical record requests in a timely and efficient manner. Obtained safeguard and protect for patient’s right to privacy. Made sure that all released information was in compliance with the request authorization companies' policy and HIPAA regulations
Senior Patient Representative
Brackenridge Hospital
06.2008 - 11.2010
- Gathered patient information/demographics interacting with registration areas and physicians' offices. Maintained master patient index by completing assigned portion of daily audit trail, corrections and communicated problems according to established procedures. Created, maintained and delivered medical records/patient care record folder. Communicated and worked closely with providers. Adhered to professional standards, hospital policies and procedures. Federal, state, and local requirements, and Iacho standards
Education
High School Diploma -
Reagan High School
Austin, TX01.2008
Skills
- Administrative Skills: Knowledge of basic office equipment, filing systems (Alpha and Numeric), Phone and Reception skills, Appointment Scheduling
- Medical Office: Data Entry, Knowledge of Medical Terminology, Medical Records and Records Management, Insurance Verification/Third Party Knowledge of insurance programs: HMO, PPO, Workman’s Comp, Tricare, Champ VA, BlueCross BlueShield, Medicare, Medicaid
- Computer Applications: Microsoft Office: Excel, Word, Type 55 WPM, Access, Outlook, PowerPoint, Internet Explorer, Scheduling Software, ECW ,Centricity and Veracity Software
- Other: HIPAA compliance training certificate OSHA and infection control training certificate
- Documentation management
- Medical terminology proficiency
- Medical billing
- ICD-10 coding
Timeline
Insurance Authorization Specialist
Texas Oncology
02.2020 - Current
Patient Services Specialist
Baylor Scott & White Hospital System
11.2019 - Current
Pre-Authorization/Patient Services Specialist
Capitol Pain Institute
07.2016 - 08.2019
Receptionist/Patient Accounts
Pain Specialist of Austin
03.2014 - 01.2016
Patient Service Representative
Austin Area OBGYN
01.2012 - 03.2014
Release of Information
Health Port Technologies
11.2010 - 01.2012
Senior Patient Representative
Brackenridge Hospital
06.2008 - 11.2010
High School Diploma -
Reagan High School