Tonika Downing-Williams
Summary
Dynamic Billing and Authorization Team Supervisor at Dominion Physical Therapy with expertise in revenue cycle management and a proven track record of reducing claim denials. Skilled in team leadership and analytical problem-solving, I drive efficient billing processes and foster strong relationships with patients and payers to enhance financial performance.
Overview
16
16
years of professional experience
Work History
Billing and Authorization Team Supervisor
Dominion Physical Therapy
Hampton
08.2024 - Current
- Oversee the financial processes, focusing on accurate and timely billing, coding, and collections to maximize revenue and ensure compliance
- Drive processes to ensure efficient and effective cash flow, reduce claim denials, and improve overall revenue cycle performance
- Supervised billing staff, managed accounts receivable, verified insurance, processed claims, analyzed billing data for trends, resolved payment discrepancies, ensured regulatory compliance, and fostered positive patient and payer relationships
- Coordinated processes for billing upfront rejections and denials, streamlining resolution efforts
- Analyzed trends, reconciled accounts, performed charge entry, and addressed inquiries regarding claims denials
Insurance analyst I & II
Tidewater Physicians Multispecialty Group
Newport News
01.2018 - 06.2024
- Conducted trend analysis and account reconciliation to resolve inquiries regarding claims denials.
- Recognized claim error trends through research on claim denials.
- Coordinated with insurance companies to obtain missing information, clarify underpayments, and arrange for adjustments.
- Review and research outstanding accounts receivable by utilizing tasks assigned in NextGen or Aging reports.
- Supported development of strategic plans for generating reports to streamline day-to-day and end-of-month operations.
- Executed the uploading and electronic posting of payments to NextGen and other accounting systems.
- Managed the input and retrieval of information from the NextGen accounting system.
- Updated and reconciled the program within the NextGen accounting system with official accounting records.
- Execute financial processes, such as ensuring payments are posted to the correct vendors and making following-up communications to maintain a relationship between the company and vendor.
Billing Specialist/HR/Scheduling
Heath Partners Home Care
Hampton
05.2014 - 01.2018
- Submitted and tracked medical claims according to Department of Medical Assistant Services, private insurance, and direct patient billing using various accounting and billing software.
- Managed accounts payable and receivable processes to ensure timely payments and accurate financial records.
- Requested service authorizations under DMAS EDCD Waiver program using DMAS and CCC+ insurances to ensure compliance and facilitate client access to necessary services.
- Created schedules for clients' in-home personal care visits to optimize staff allocation and enhance service delivery.
- Establish and maintain procedures to monitor the integrity and continuity of client records in compliance with HIPAA/DMAS guidelines.
- Coordinated onboarding processes and facilitated continuing education credits for new hires.
- Admissions and Discharge of clients
Office Manager
Elite Home Health Care
Newport News
01.2010 - 08.2012
- Managed daily operations of staffing and human resources.
- Led team of 50 employees, overseeing performance and development.
- Addressed conflicts between employees and clients.
- Developed and maintained procedures for agency to effectively record, track, analyze, and report data.
- Processed applications for hiring, maintained personnel records and evaluations.
- Compiled and analyzed data for daily, weekly, and monthly operational reports.
- Tracked and organized inventory levels for supplies
- Scheduling
- Medical Billing, obtained authorizations, admission, and discharge of patients.
Education
Associates - applied science in Medical Administration
MEDICAL Careers Institute
Newport News, VA01-2009
Skills
- Medical billing
- Billing processes
- Healthcare billing
- Revenue cycle management
- Specialty billing
- Insurance verification
- NexGen
- Epic
- Webpt
- Management
- Staff development
- Leadership
- Team building
- Organizational skills
- Deadline management
- Analytical abilities
- Problem-solving abilities
- Communication
- Interpersonal skills
- Behavioral Health
- Cardiology
- Nephrology
Security Clearance
Secret Security Clearance
Timeline
Billing and Authorization Team Supervisor
Dominion Physical Therapy
08.2024 - Current
Insurance analyst I & II
Tidewater Physicians Multispecialty Group
01.2018 - 06.2024
Billing Specialist/HR/Scheduling
Heath Partners Home Care
05.2014 - 01.2018
Office Manager
Elite Home Health Care
01.2010 - 08.2012
Associates - applied science in Medical Administration
MEDICAL Careers Institute