Toni Miller
Pensacola,FL
Summary
Organized and proactive individual that thrives on meeting challenging goals and exceeding expectations. Highly motivated, independent worker with excellent problem-solving and analytical skills. Hardworking and passionate with strong medical background. Eager to secure a position where I can grow and help a team achieve company goals.
Overview
11
11
years of professional experience
Work History
Financial Clearance Representative
Allina Health
05.2025 - Current
- Initiated, tracked, and secured prior authorizations for procedures and surgeries within payer-specific timeframes
- Requested clinical information from providers & facilities
- Analyzed clinical documentation for medical necessity and compliance with ICD-10 and CPT coding standards
- Researched, resolved, and appealed denied authorizations, liaising providers to secure coverage
- Served as the primary contact for insurers and providers regarding authorization status
- Coordinated with internal teams to optimize workflow processes
- Collaborated with multiple roles within management on departmental policies development and implementation
Associate Clinical Administrative Coordinator
Optum - Home and Community Care
05.2023 - 05.2024
- Worked with facilities, providers and the clinicals team to manage requests for services for members
- Identified and resolved complex issues promptly
- Exceeded monthly quality and performance expectations by over 15%
- Requested clinical information from providers & facilities
- Made outbound calls to providers to verify clinical information
- Coordinated with internal teams to optimize workflow processes
Customer Service Coordinator (Contract)
Optum - ProHealth
11.2022 - 03.2023
- Proactive response to inquiries from patient, provider and internal medical personnel
- Processed medication refills and referrals
- Extremely high call volume and data entry
- Resolved complex issues
- Scheduled appointments for multiple locations and adherence to a variety of protocols
- Exceeded quality and performance expectations
Surgery Coordinator
Memphis Veterinary Specialists
03.2022 - 11.2022
- Handled high volume calls, inbound & outbound
- Managed scheduling for multi doctor surgery department
- Handled incoming and outbound referrals
- Identified and resolved complex issues
- Obtained and updated patient demographic information
- Assisted with tracking of lab results and imaging studies related to patient care
Marketing Director and Sales Manager
The Fam Boutique
02.2017 - 02.2022
- 400k a year online and in-person retail sales
- Mentored and trained new employees on company policies and procedures.
- Assigned, prioritized and delegated tasks and responsibility to employees.
Veterinary Technician
Central Animal Hospital
03.2015 - 03.2016
- Assisted in surgery, sterile prep, scrub in and anesthesia monitoring
- Performed in-hospital lab testing & prepare specimens for outside labs
- Processed prescription refills
- Provided client education and superb client care
- Mentored and trained new employees on company policies and procedures.
Education
High School Diploma -
Munford High School
TN05-2004
Skills
- Revenue Cycle Management
- Insurance Verification & Eligibility
- Payer Guidelines & Regulations
- EPIC Software
- Cross-Functional Communication
- Attention to Detail
- Medical Terminology and Coding
- Analytical and Critical Thinking
Timeline
Financial Clearance Representative
Allina Health
05.2025 - Current
Associate Clinical Administrative Coordinator
Optum - Home and Community Care
05.2023 - 05.2024
Customer Service Coordinator (Contract)
Optum - ProHealth
11.2022 - 03.2023
Surgery Coordinator
Memphis Veterinary Specialists
03.2022 - 11.2022
Marketing Director and Sales Manager
The Fam Boutique
02.2017 - 02.2022
Veterinary Technician
Central Animal Hospital
03.2015 - 03.2016
High School Diploma -
Munford High School