Summary
Overview
Work History
Education
Skills
Timeline
Generic

Tihema Alford

Bronx,NY

Summary

Detail-oriented Revenue Cycle Data Specialist with a systematic nature and good grasp of billing processes. Successful planner and problem-solver. Ready to apply 20 years' experience and take on a challenging role.

Overview

20
20
years of professional experience

Work History

Data Specialist-Revenue Cycle

Mount Sinai Health System-Department of OBGYN
New York, New York
08.2009 - Current
  • Verified insurance eligibility, coverage levels, and benefit parameters prior to submission of precertification requests.
  • Reviewed patient medical records to determine medical necessity for requested services and procedures.
  • Resolved any discrepancies identified during the precertification process.
  • Provided follow-up on pending precertification requests to ensure timely processing.
  • Generated monthly financial statements for customers.
  • Investigated and responded to customer inquiries related to billing issues.

Data Specialist

Beth Israel Medical Center-Professional Billing
New York, New York
09.2005 - 08.2009
  • Reviewed medical bills for accuracy prior to submission to insurance companies.
  • Educated patients on how to access online portals for scheduling appointments, making payments or viewing lab results.
  • Answered incoming calls and responded to customer inquiries in a timely manner.
  • Provided accurate information regarding insurance coverage, billing and payment processing.
  • Collected patient demographic and insurance information for new patients.
  • Resolved customer complaints promptly and professionally.
  • Verified patient eligibility for benefits according to healthcare policies and procedures.

Patient Service Representative

St.Lukes Roosevelt Hospital
New York, NY
08.2004 - 09.2005
  • Verified insurance information, collected payments, and scheduled appointments.
  • Processed referrals from primary care physicians to specialists for further treatment or evaluation.
  • Ensured all necessary paperwork was completed prior to patient visits.
  • Informed patients about payment options, billing policies, and procedures related to their visit or procedure.
  • Inputted patient demographic data into electronic health record system.
  • Assisted with scheduling follow-up appointments according to provider availability.
  • Adhered to HIPAA regulations when handling confidential patient information.
  • Scheduled patient appointments and procedures.

Education

Medical Management

The Roxbuury Institute For Medical Management
Queens, NY
06-2007

High School Diploma -

Hillside High School
Hillside, NJ
06-1986

Skills

  • Knowledge of medical terminology
  • Medical Coding
  • Creative Problem Solver
  • Exceptional Workflow Management
  • Skilled in Call Center Operations
  • Expert in Commercial and Private Insurance
  • Billing and collection procedures expert
  • Patient Referrals expert

Timeline

Data Specialist-Revenue Cycle

Mount Sinai Health System-Department of OBGYN
08.2009 - Current

Data Specialist

Beth Israel Medical Center-Professional Billing
09.2005 - 08.2009

Patient Service Representative

St.Lukes Roosevelt Hospital
08.2004 - 09.2005

Medical Management

The Roxbuury Institute For Medical Management

High School Diploma -

Hillside High School

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Tihema Alford