Summary
Overview
Work History
Education
Skills
Timeline
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Tonia Combs

Troy,OH

Summary

Proven leader in healthcare administration, adept at multitasking and fostering team collaboration, significantly enhancing operational efficiency in client healthcare advocacy . Highly organized professional with proven track record in coordinating complex tasks and ensuring seamless in medical administration, with exhibiting a high standard for maintaining discretion and confidentiality. Excelled in strategic planning and customer service management, achieving notable improvements in project execution and client satisfaction.

Renowned for fostering teamwork and adapting to dynamic environments, making significant contributions to organizational success.

Self-motivated healthcare advocate bringing proven leadership, organizational and customer relations skills. Independently solves problems and keeps teams on task to handle diverse business requirements.

Dependable coordinator providing excellent office management and administrative support. Possesses strong communication and interpersonal skills with demonstrated ability to manage competing priorities. Creative problem solver with strong analytical and critical thinking skills.

Overview

20
20
years of professional experience

Work History

Clinical Denial Coordinator

Premier Healthcare
07.2024 - Current
  • Manage and organize materials while streamlining administrative clinical authorization process. Supporting clinical prior authorization operations.
  • Enhanced customer satisfaction by responding promptly to inquiries and addressing concerns professionally.
  • Enhanced operational workflows by maintaining well-organized documentation systems and updating records accurately as needed.
  • Entered data, generated reports, and produced tracking documents.
  • Improved team productivity with regular communication and progress updates, fostering a collaborative work environment.
  • Managed project timelines for successful completion, ensuring milestones were met and deadlines were adhered to.
  • Collaborated with department heads to develop strategic plans aligning with overall company objectives, fostering a unified approach toward shared goals.
  • Manage vendor relationships to secure best quality of services and products for organizational needs.
  • Developed comprehensive training materials for new staff, leading to quicker onboarding and higher initial productivity levels.

Disability Claims Specialist

UnitedHealth Group
01.2021 - 07.2024
  • Played a critical role in resolving customer complaints by addressing concerns and providing clear explanations about claim decisions, maintaining positive relationships with clients.
  • Effectively negotiated settlements for disputed claims, minimizing company exposure while maintaining client satisfaction levels.
  • Increased client retention rates by building strong relationships through regular follow-ups and updates on claim status.
  • Provided exceptional service to clients through prompt response times, clear explanations of policy terms, and compassionate support throughout the claims process.
  • Reduced claim processing time by conducting thorough assessments and providing accurate documentation for each case.
  • Streamlined communication between departments by establishing clear protocols, leading to enhanced collaboration in resolving claims issues.
  • Collaborated with healthcare providers to obtain crucial information, leading to more accurate and faster decision-making on claims.
  • Managed high caseloads effectively, ensuring all disability claims were processed promptly and accurately.
  • Enhanced customer satisfaction with timely communication and empathetic support during the claims process.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
  • Maintained confidentiality of patient finances, records, and health statuses.
  • Communicated effectively with staff members of operations, finance and clinical departments.

Medicare Medicaid Advocate 4Me

UnitedHealth Group
08.2019 - 01.2021
  • Delivered friendly service and offered expert support in every interaction.
  • Maintained positive relationships with community to build and nurture dynamic partnerships.
  • Established trusting relationships with clients by maintaining open lines of communication throughout the entire representation process.
  • Worked effectively with fellow team members to coordinate effective solutions to any question or concern.
  • Managed complex caseloads with diligence, prioritizing tasks to ensure timely resolution of cases.
  • Made referrals to appropriate services, following up to confirm patients received access to required care.
  • Managed sensitive cases with discretion, protecting client confidentiality and trust.

Patient Finance Specialist - Reimbursement

Dayton Children Hospital
02.2018 - 08.2019
  • Provided accurate financial patient billing support, forecasts for management, aiding in strategic decision making.
  • Prepared and submitted responses to requests and requirements of auditors, regulators and investors.
  • Formulated financial data and analysis to support risk management and made recommendations to management.
  • Identified process issues and made recommendations for improvement or correction.
  • Prepared and determined content for financial and business metric reporting.
  • Mentored junior team members in best practices related to financial analysis, modeling techniques, and professional development.
  • Contacted customers to immediately find resolutions for escalated issues.

Credit Reimbursement Specialist PFS

Premier Healthcare
01.2017 - 02.2018
  • Provided exceptional customer service when responding to patient inquiries about reimbursement status and procedures.
  • Supported company objectives by maintaining compliance with all relevant state and federal regulations governing medical billing practices.
  • Identified trends in reimbursement denials, recommending process improvements to minimize future occurrences.
  • Advanced internal communication channels by sharing best practices among colleagues, fostering an environment of continuous learning and improvement.
  • Maintained comprehensive knowledge of healthcare billing practices, staying current on industry updates and changes in regulations.
  • Contributed to increased team productivity by consistently meeting or exceeding individual processing goals.
  • Coordinated with insurance providers to verify customer's policy benefits in relation to claims.
  • Improved departmental accuracy through meticulous attention to detail while reviewing claims submissions.
  • Conducted regular audits of billing records, identifying areas where inconsistencies could be addressed to optimize efficiency within the department.
  • Maintained patient confidentiality by adhering to strict HIPAA guidelines when handling sensitive information.

Executive Administrative Assistant

UTMB MD Anderson Cancer Center
08.2004 - 01.2017
  • Maintained confidentiality when handling sensitive information, protecting company interests and employee privacy.
  • Handled administrative tasks such as expense report processing or invoice reconciliation efficiently; allowing executives to focus on high-priority responsibilities without distraction.
  • Coordinated and booked airfare, hotel and ground transportation and prepared itinerary to facilitate successful trips.
  • Managed inventory levels for office supplies, reducing waste while guaranteeing availability when needed.
  • Responded to emails and other correspondence to facilitate communication and enhance business processes.
  • Handled scheduling for executive's calendar and prepared meeting agenda and materials.
  • Reviewed incoming communications for urgency or importance; prioritized correspondence accordingly for executive review or action.
  • Scheduled appointments promptly, ensuring optimal use of executive time while minimizing conflicts or cancellations.
  • Managed budgets and expenses, maintaining financial records for accurate reporting and analysis.
  • Collaborated with cross-functional teams, expediting project completion times and enhancing overall efficiency.
  • Seamlessly interacted with colleagues to plan and complete special projects.
  • Enhanced communication between departments through proactive coordination of meetings and events.
  • Organized travel arrangements, ensuring smooth transitions for executives during business trips.
  • Produced accurate office files, updated spreadsheets, and crafted presentations to support executives and boost team productivity.
  • Drafted professional correspondence on behalf of executives, fostering strong relationships with clients and partners alike.
  • Assisted in event planning efforts, executing successful corporate functions that bolstered brand image and networking opportunities.
  • Coordinated complex annual meeting involving multiple presenters, high number of global attendees and robust budget encompassing livestream production, remote location arrangements and senior executive accommodations.

Education

Bachelor of Science - Chemistry - Pre Medicine

Texas Southern University
Houston, TX

High School Diploma -

Michael DeBakey HS For Health Professions
Houston, TX
05-1985

Skills

  • Multitasking and organization
  • Customer service
  • Data entry
  • Decision-making
  • Work Planning and Prioritization
  • Relationship building
  • Team leadership
  • Coaching and mentoring
  • Customer service management
  • Discretion and confidentiality
  • Client coordination
  • Microsoft office
  • Medical billing
  • Patient registration
  • Attention to detail
  • Verbal and written communication

Timeline

Clinical Denial Coordinator

Premier Healthcare
07.2024 - Current

Disability Claims Specialist

UnitedHealth Group
01.2021 - 07.2024

Medicare Medicaid Advocate 4Me

UnitedHealth Group
08.2019 - 01.2021

Patient Finance Specialist - Reimbursement

Dayton Children Hospital
02.2018 - 08.2019

Credit Reimbursement Specialist PFS

Premier Healthcare
01.2017 - 02.2018

Executive Administrative Assistant

UTMB MD Anderson Cancer Center
08.2004 - 01.2017

Bachelor of Science - Chemistry - Pre Medicine

Texas Southern University

High School Diploma -

Michael DeBakey HS For Health Professions

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Tonia Combs