- I enjoy helping others and giving back to the community
- Avid Reader
- I like trying new recipes and food trends
- I enjoy cooking for friends and family gatherings
- Event Planning
TONI MAY-HARRISON
Flanders
Summary
Diligent Reimbursement Coordinator with a proven track record in efficiently managing reimbursement processes within healthcare organizations. Skilled in resolving complex billing issues and utilizing medical coding knowledge to ensure accurate and timely reimbursements. Seeking a new role to enhance efficiency and contribute to the success of a healthcare organization.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Clinical Reimbursement Coordinator RN
Genesis Healthcare Holly Manor Center
01.2023 - Current
- Managed high-volume workloads through effective prioritization and organization, consistently meeting deadlines while maintaining accurate records.
- Established strong relationships with payer representatives, fostering open communication channels that facilitated problem resolution and expedited claim approvals.
- Developed comprehensive reports for management that tracked key performance indicators related to reimbursement activities.
- Leveraged strong analytical skills to identify trends in payer behavior, enabling proactive adjustments to claims submission strategies when needed.
- Increased staff productivity by providing ongoing training and support on relevant software systems and tools.
- Maintained up-to-date knowledge of industry regulations, ensuring compliance with all applicable laws and guidelines.
- Collaborated with cross-functional teams to develop strategies for maximizing revenue reimbursement opportunities.
- Improved reimbursement rates with regular audits of insurance contracts to ensure compliance and proper coding practices.
- Delivered timely information to insurance representatives to resolve common and complex issues.
RN Case Manager
LHC Group
06.2021 - 12.2022
- Provided emotional support to patients coping with chronic illness or end-of-life decisions, fostering resilience during difficult times.
- Managed complex cases involving multiple comorbidities, requiring close monitoring and coordination of various healthcare services.
- Collaborated closely with physicians to develop individualized treatment plans, supporting optimal patient outcomes.
- Educated patients and families on available community resources, facilitating access to necessary support services.
- Enhanced patient care by developing comprehensive care plans and coordinating with interdisciplinary healthcare teams.
- Served as a key liaison between patients, families, and healthcare providers, fostering open communication and trust among all parties involved in the care process.
- Implemented evidence-based practices to improve overall clinical performance and patient outcomes.
Registered Nurse Supervisor
Genesis Healthcare
01.2020 - 06.2021
- Handle the queries and problems of the patients and their families and resolving them
- Responsible for organizing staff and workloads
- Work collaboratively with other IDT members to develop, implement and evaluate plans of care
Registered Nurse
Genesis Healthcare
01.2014 - 01.2020
- Utilize strong assessment skills to implement appropriate patient centered care
- Advocate and implement total patient care through a team nursing process
- All routes medication administrations including, PICC and Implanted ports
Registered Nurse/ Midwife
SPANISH TOWN HOSPITAL
01.2006 - 01.2012
- Monitoring and recording mothers’ condition before, during and after delivery
- Implement and maintained the changes in maternity unit regarding prioritization and delegation
- Caring for the infant from birth to school age
Registered Nurse
SPANISH TOWN HOSPITAL
01.2002 - 01.2005
- Responsible for direct patient care including regular monitoring, medications, and report writing
- Making ethical decisions related to consent and confidentiality
- Teaching proper nursing procedures to junior nurses and students
Education
Bachelor of Science - Nursing
Grand Canyon University
Phoenix, AZ07-2022
Certification - Registered Midwife
KINSGTON SCHOOL OF NURSING
01.2006
Certification - Registered General Nurse
EXCELSIOR COMMUNITY COLLEGE
01.2001
Skills
- Excellent communication skills
- Computer literate: Microsoft Word
- HIPAA compliance
- Appeals handling
- Utilization review
- Explanation of benefits
- Medicaid
- Medical coding (ICD-10)
- Medicare
- Private insurance
- Managed care
- Healthcare regulations
Certification
- New Jersey Board of Nursing License (active)
- Basic Life Support for Healthcare Providers
Interests
Timeline
Clinical Reimbursement Coordinator RN
Genesis Healthcare Holly Manor Center
01.2023 - Current
RN Case Manager
LHC Group
06.2021 - 12.2022
Registered Nurse Supervisor
Genesis Healthcare
01.2020 - 06.2021
Registered Nurse
Genesis Healthcare
01.2014 - 01.2020
Registered Nurse/ Midwife
SPANISH TOWN HOSPITAL
01.2006 - 01.2012
Registered Nurse
SPANISH TOWN HOSPITAL
01.2002 - 01.2005
Certification - Registered Midwife
KINSGTON SCHOOL OF NURSING
Certification - Registered General Nurse
EXCELSIOR COMMUNITY COLLEGE
- New Jersey Board of Nursing License (active)
- Basic Life Support for Healthcare Providers
Bachelor of Science - Nursing
Grand Canyon University
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