Tomica Tatem
Chesapeake
Summary
Dynamic Billing and Credentialing Specialist with proven expertise at Panacea Behavioral Health, adept in ICD-10 and electronic health records management. Successfully managed over 1,000 patient accounts, enhancing claim recovery processes and resolving discrepancies efficiently. Known for exceptional communication skills and a commitment to accuracy in billing and credentialing practices. Accomplished credentialing specialist with several years of experience accomplishing demanding information security-related tasks. Maintains strict data accuracy, retention, and access expectations according to internal productivity demands. Organized, thorough approach toward handling credentialing procedures and addressing requests for access. Tracked and compiled information management needs to ascertain access tiers.
Overview
14
14
years of professional experience
Work History
Billing and Credentialing Specialist
Panacea Behavioral Health and Wellness Center
Virginia Beach
08.2022 - 08.2024
- Managed patient billing and accounts for over 1,000 active patients, ensuring daily submission of 100+ claims.
- Completed specialty credentialing for 15 providers across 10 panels.
- Conducted regular audits to verify accuracy and compliance in patient accounts.
- Integrated in-house billing systems, incorporating claim payment data into Electronic Health Record (EHR).
- Adapted to diverse payer preferences by preparing both paper and electronic claims.
- Established procedures for addressing claim denials, enhancing recovery processes.
- Contributed to onboarding new employees and interns by providing specialized training.
- Delivered crucial administrative support while maintaining professionalism in business communications.
Patient Account Representative
Nephrology Associates of Tidewater
Norfolk
09.2021 - 09.2022
- Provided comprehensive administrative support, submitting electronic and paper claims to multiple insurance companies.
- Executed cash posting, bank deposits, and prior authorizations while interpreting EOBs.
- Posted insurance payments and corrected denied claims for resubmission through clearing house.
- Registered patients in EHR system and collected payments on accounts efficiently.
- Managed patient inquiries and served as liaison between behavioral health office and insurance carriers.
- Resolved issues with problematic claims through effective communication with insurance companies.
- Conducted data entry, verified insurance information, and followed up on outstanding claims.
Medical Biller
Ocean Psychiatric Group
06.2015 - 09.2021
- Submitted electronic and paper claims to primary, secondary, and third-party insurance companies.
- Managed cash posting, bank deposits, prior authorizations, and interpretation of EOBs.
- Posted insurance payments and corrected denied claims for resubmission through Athena clearinghouse.
- Registered patients in EHR system and collected payments on patient accounts.
- Handled patient calls and served as liaison between behavioral health office and insurance carriers.
- Collaborated with insurance companies to resolve problematic claims and ensure timely payments.
- Conducted data entry, verified insurance information, and performed follow-ups on outstanding claims.
Medical Receptionist
Pedro Hasas M.D. Internal and Geriatric Medicine
02.2014 - 06.2015
- Provided administrative support by scheduling appointments and verifying insurance coverage.
- Checked patients in and out, collecting copayments efficiently.
- Maintained open communication among patients, physicians, and staff for seamless operations.
- Obtained authorizations and performed Accu check blood sugar tests.
- Recorded patient PT INR levels accurately and prepared medical records requests.
- Managed document processing through faxing and scanning to ensure compliance.
Medical Receptionist/ Patient Financial Services
Medical Temporaries
01.2011 - 12.2014
- Oversaw medical front desk operations, managing scheduling, billing, and insurance records for major carriers and Medicaid.
- Maintained effective communication among patients, physicians, staff, and laboratory personnel.
- Scheduled medical screenings and ensured prompt follow-up on results.
- Obtained physician transcription and processed patient co-payments efficiently.
- Prepared accounts for collections and responded to attorney requests for itemized billing statements.
Medical Biller/Patient Account Rep
Atlantic Psychiatric Services
01.2012 - 12.2013
- Applied payments accurately to patient accounts, ensuring financial integrity.
- Resolved discrepancies in payments through thorough research and verification of CPT and ICD-9 codes.
- Addressed EOB rejections and outstanding account issues effectively.
- Reviewed billing edits and supplied corrected information to insurance providers promptly.
- Executed diligent follow-up to guarantee complete collection of payments.
- Posted insurance payments while processing EOBs, remits, and electronic claims systematically.
Education
Licensed Commonwealth of Virginia Notary -
National Notary Association
01.2021
Medical Billing and Coding & Medical Assisting - Medical Billing and Coding, Medical Assisting
Mountain State University
Beckley, WV01.2011
Business Applications - Business Operations
Kee Business College
Chesapeake, VA01.2004
Skills
- ICD-10, CPT-10, and HCPCS
- Electronic health records management
- Allscripts Pro, Epic, and Athena
- Medical billing and coding
- Patient billing and insurance processes
- Claim submission and follow-up
- Claim correction and issue resolution
- Database management and data entry
- Medical administrative support
- Psychiatric provider credentialing
- Software applications proficiency
References
Available Upon Request
Languages
English
Native/ Bilingual
References
References available upon request.
Timeline
Billing and Credentialing Specialist
Panacea Behavioral Health and Wellness Center
08.2022 - 08.2024
Patient Account Representative
Nephrology Associates of Tidewater
09.2021 - 09.2022
Medical Biller
Ocean Psychiatric Group
06.2015 - 09.2021
Medical Receptionist
Pedro Hasas M.D. Internal and Geriatric Medicine
02.2014 - 06.2015
Medical Biller/Patient Account Rep
Atlantic Psychiatric Services
01.2012 - 12.2013
Medical Receptionist/ Patient Financial Services
Medical Temporaries
01.2011 - 12.2014
Licensed Commonwealth of Virginia Notary -
National Notary Association
Medical Billing and Coding & Medical Assisting - Medical Billing and Coding, Medical Assisting
Mountain State University
Business Applications - Business Operations
Kee Business College
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