Tisha Barker
Panama City,USA
Summary
Bringing more than 25 years of dedicated experience, I have developed a robust skill set in claims management, customer service, and administrative support. My exceptional oral and written communication abilities enable me to connect effectively with diverse audiences. I excel in proactively identifying priorities and streamlining processes to enhance efficiency. My expertise lies in accurately interpreting and applying various regulations, policies, and procedures, ensuring compliance and operational excellence. Driven by a passion for delivering high-quality work, I strive to surpass company objectives and contribute positively to the overall success of the organization.
Overview
26
26
years of professional experience
1
1
Certification
Work History
Referral Coordinator/Medical billing
PanCare of Florida Inc.
Panama City, USA
01.2023 - Current
- Coordinate and process referrals
- Submit and track authorizations
- Interface with corporate management, administrative personnel, medical, dental and behavioral staff
- Identifies the health needs of the patient and the expectations of the family
- Makes an assessment of the resources and support network at the patient's disposal
- Assists in development, implementation, and revision of individual treatment plans; assures that services provided are specified in the Treatment Plan; and monitors progress toward treatment goals
- Maintains an active caseload, providing interventions as needed and within area of expertise and limits of credentials; assures procurement of additional services as needed
- Reviews and facilitates, if appropriate, mental health referrals from other sources such as primary care, school health, etc
- Offers alternative recommendations where necessary
- Maintains patient and program records in accordance with applicable standards and regulations, grant requirements, etc
- Maintains a high level of ethical conduct regarding confidentiality, dual
- Participates in continuing education activities, remaining knowledgeable
- Obtain dme prior authorization, appeal and bill out for dme
- Billing and coding
Senior Medical Claims Specialist
Contracted employee
Arizona, USA
01.2019 - 02.2024
- Coded and processed over 4000 claims monthly for payment ensuring all information is accurate and supplied before eligible payments are made
- Researched and analyzed claim and coordination of benefit issues
- Analyzed compiled data regarding pending claims and make recommendations to superiors for improving processing
- Proficient usage of various claims processing software such as Trizetto Facets, FEP Direct, Kareo, AdvancedMD, Athenahealth, and NextGen Healthcare
- Assisted in training other claims associates on proper handling and evaluation of professional and facility claims
- Assisted with assigned escalated projects to resolve major facility provider claims issues
Assistant Manager
Renfroe's Market
LaFayette, USA
02.2023 - 01.2024
- Assisted in the management of daily operations, ensuring smooth and efficient workflow
- Supervised and trained a team of XX employees, providing guidance and support to maximize productivity
- Collaborated with the manager to develop strategies for achieving sales targets and improving customer satisfaction
- Conducted regular inventory checks to maintain accurate stock levels and minimize loss due to shrinkage
- Resolved customer complaints or concerns promptly, ensuring high levels of customer service at all times
- Assumed managerial responsibilities in the absence of the manager, overseeing all aspects of operations
- Created training materials and conducted training sessions for new hires on company policies and procedures
- Analyzed sales data to identify trends and opportunities for improvement, implementing effective strategies accordingly
- Managed cash handling procedures, including opening/closing registers, preparing deposits, and reconciling discrepancies
- Assisted in the recruitment, selection, and onboarding of new employees, ensuring a smooth transition into the team
Medical Assistant/Office Manager
Rainbow Pediatrics
Panama City Beach, USA
02.2013 - 01.2019
- Assisted practice manager in office growth through maintenance and development of existing and new patients
- Created welcoming environment for patients and parents by greeting and assisting, as well as quickly responding to the patients inquiries and needs
- Answered questions and advised patients of information regarding HIPPA policy, and practice policies
- Sorted, opened and routed incoming correspondence and deliveries to senior leaders respond quickly to practice and patients needs
- Produced highly accurate internal and external letters and memoranda
- Answered multi-lined phone system efficiently and handled each call appropriately
- Identified training needs and provided ongoing training opportunities as needed
- Interviewed applicants to obtain experience and knowledge of position applied for
- Filled in as a Medical Assistant, Lab Tech, Front desk, scheduling, checkout when needed
- Processed and closed end of day
- Assisted with providing patients with accuracy and caring to meet their needs
Patient Registration Specialist
Family Physicians Group
Valley, USA
01.1999 - 09.2018
- Scheduling patients
- Checking patients in and out
- Collect copayments
- Insurance verification
- Out patient scheduling for diagnostic imaging, specialist etc
- Scheduled surgeries for ASC
- Work denials, self pay and aging reports for insurance companies and patient accounts
- Assist patients and families with questions and concerns
- Hippa certified
Senior Underwriter/finance lead
JD Byrider / CNAC Finance
Opelika, USA
01.2008 - 01.2013
- Operated in high-volume call center environment to provided skilled assistance to more than 150 customers each day
- Assisted customers via inbound calls inquiring supplemental health insurance policies; provided current and accurate information, state insurance and tax regulations
- Provided support to customers regarding financials, payments, billing, existing products and services
- Advised customers, and brokers with information on customer policies according to state and federal regulations
- Surpassed performance goals by approaching all interactions with resourcefulness, organization and customer-centric solutions
- Increased efficiency and team productivity by promoting adherence to operational best practices and company policies
- Retained accounts by addressing potential cancellations and offering catered solutions to maintain account status
Education
Certificate - Medical Billing & Coding
Florida Technical College
12.2024
Skills
- **Medical Coding and Billing Experience**
- Medical Coding
- Medical Billing
- Proficient in Athenahealth
- Familiar with ICD-10 (International Classification of Diseases, 10th Revision)
- Knowledgeable in Healthcare Management
- Medical Scheduling
- Experienced with eClinicalWorks
- Medical Office Experience
- Proficient in Scheduling Software
- Strong Knowledge of Medical Terminology
- Accurate Documentation Skills
- CPT Coding (Current Procedural Terminology)
- Insurance Precertification Processes
- Note-taking and Documentation
- Oversight of Patient Records
- Referral Tracking
- Insurance Verification
- Proficiency in Microsoft Office
Certification
- BLS Certification, Present
- CPR Certification
Assessments
- Office manager, Proficient, 06/01/20
- Scheduling and budgeting, Proficient, 06/01/20
- HR: Compensation & benefits, Proficient, 06/01/21
References
References available upon request.
Timeline
Assistant Manager
Renfroe's Market
02.2023 - 01.2024
Referral Coordinator/Medical billing
PanCare of Florida Inc.
01.2023 - Current
Senior Medical Claims Specialist
Contracted employee
01.2019 - 02.2024
Medical Assistant/Office Manager
Rainbow Pediatrics
02.2013 - 01.2019
Senior Underwriter/finance lead
JD Byrider / CNAC Finance
01.2008 - 01.2013
Patient Registration Specialist
Family Physicians Group
01.1999 - 09.2018
Certificate - Medical Billing & Coding
Florida Technical College
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