Tomeca Haggins
Summary
Experienced Revenue Cycle Representative skilled in healthcare billing and coding, optimizing claims management and enhancing patient advocacy. Strong problem-solving and communication abilities ensure accurate reimbursements and efficient workflows. Specializes in claims processing and case management, maximizing reimbursement and operational efficiency in fast-paced healthcare environments.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Revenue Cycle Representative
Emory Hospital
06.2025 - Current
- Managed full cycle of patient claims, including billing, coding, and resolution of complex reimbursement issues, ensuring timely reimbursements.
- Insurance & Billing: Verifies insurance, updates demographic data, and submits documentation to maximize reimbursement.
- Submitted claims electronically and utilized payer portals to track claims status through adjudication.
- Identified and reported issues needing resolution to leadership, following up on accounts to minimize delays in reimbursement.
- Verified and updated patient demographics and registration information to ensure accuracy in records.
- Resolve issues independently by applying root cause analysis to determine the necessary steps for resolution.
- Communicated financial policies and assisted in resolving outstanding account balances for improved patient understanding.
- Updated knowledge of billing guidelines for governmental and third-party payers and insurance plans.
- Ability to work in a fast-paced, diverse environment while maintaining attention to detail.
- Effectively navigate multiple systems, programs, and electronic medical records.
- Demonstrate proficiency in medical terminology and healthcare billing practices.
- Communicate professionally and effectively with customers, management, and peers.
- Collaborate with a diverse team to meet departmental goals.
- Maintain proficiency in healthcare insurance billing, coding, and reimbursement guidelines.
- Proficiency in Microsoft Office and healthcare billing software.
- Strong understanding of insurance billing, reimbursement, and coding guidelines.
- Excellent communication and problem-solving skills.
- Works with managers to formulate a plan for professional development.
- Coordinated resources for revenue cycle functions across clinical specialties to ensure consistent workflow and optimize utilization of resources.
Case Management
Piedmont Henry Hospital
12.2024 - 06.2025
- Develop and implement individualized care plans: Coordinate with service providers to ensure comprehensive care.
- Monitored client progress, adjusting care plans to meet evolving needs.
- Facilitated communication between clients and service providers, conducting regular follow-up meetings to ensure care continuity.
- Evaluated the effectiveness of care plans and services: Provided crisis intervention.
- Educate clients and families about available resources: Work collaboratively with a multidisciplinary team to ensure holistic care.
- Maintained accurate case records, assisting clients in navigating community resources and services.
- Develop client profiles: Establish treatment plans: Meet regularly with clients to assess needs.
- Document treatment and response: Discuss progress with healthcare professionals: Coordinate with insurance companies: Research Alternative treatment options.
Case Manager / Legal Administrative Specialists
Department Of Veteran Affairs
05.2019 - 05.2025
- Legal Advisory Services: Advise and provide information to the public via telephone, email, video, or chat regarding veterans' benefits and rights.
- Case Manage Benefits Program Expertise: Assess short-term and long-term circumstances to guide individuals in choosing among various benefits programs.
- Demonstrate expertise in compensation and pension benefits, home loan eligibility, education, health care, life insurance, burial benefits, vocational rehabilitation services, fiduciary assistance, and other federal, state, and local assistance programs.
- Assisted individuals in gathering documents and evidence for benefit claims, resolved issues through inquiries, and facilitated completion of claim and appeal tasks, improving claim accuracy and timeliness.
- Coordinated counseling sessions with veterans, dependents, and beneficiaries to discuss available benefits through VA and other agencies, promoting informed decision-making regarding their options.
- Provided support for various federal, state, and local assistance programs, including compensation and pension benefits and home loan eligibility.
- Case Management Claim and Appeal Processing: Execute various claim and appeal-related tasks, such as providing detailed status updates in line with mandatory scripting requirements.
- Utilize extensive knowledge of VA benefits and services, claim and appeal processing procedures, and information available within the systems of record.
- Case & Document Management: Explain document requirements for timely claims and appeals processing.
- Prepared technical correspondence for veterans and dependents, providing benefit information, representation rights, and inquiry responses, enhancing communication and understanding.
- Explain relevant legal provisions, regulations, and administrative practices applicable to specific cases.
- Explains pertinent legal provisions, regulations, and related administrative practices and their application to specific cases.
- Process change of address requests, establish or update direct deposit banking information, and manage tasks related to burial allowance claims, dependency claims, and more.
- Initiates inquiries to resolve errors, delays, or other problems in obtaining benefits. Completes claim and appeal related work.
Education
Master’s Degree - Social Work
Walden University
01-2026
Master’s Degree - Health Care Management
University of Phoenix
07-2021
LPN -
Ultimate Medical Academy
01-2018
Skills
- Claims Processing
- Billing
- Insurance Verification
- Pre Registration
- Patient Access
- Claims Specialist
- Revenue Management
- Billing Management
- Health Information Management
- Data Analysis
- Data Entry
- Epic Specialist
- Radiology
- Case Management
- Management
Certification
- Certified Epic Specialist
- Multi-Tasking
- Patient Care and Case Management Specialist
References
Available Upon Request.
Timeline
Revenue Cycle Representative
Emory Hospital
06.2025 - Current
Case Management
Piedmont Henry Hospital
12.2024 - 06.2025
Case Manager / Legal Administrative Specialists
Department Of Veteran Affairs
05.2019 - 05.2025
Master’s Degree - Social Work
Walden University
Master’s Degree - Health Care Management
University of Phoenix
LPN -
Ultimate Medical Academy