TONYA FAVORITE
Fort Worth,TX
Summary
Highly motivated professional with strong work ethic, adaptability, and exceptional interpersonal skills. Background includes valuable experience in Medicare/Medicaid-related services, ensuring accuracy and efficiency in pre-authorizations, claims, and appeals. Successfully managed multiple projects simultaneously, ensuring timely completion and optimal use of resources. Demonstrated proficiency in coordinating team efforts and maintaining clear communication, showcasing strong organizational and time-management skills.
Overview
17
17
years of professional experience
Work History
Surgery Scheduling Coordinator – Vascular Surgery
Texas Health Resources
Arlington, TX
01.2019 - 12.2025
- Monitored compliance with regulatory standards in scheduling practices, ensuring adherence to policies and procedures across the organization.
- Resolved scheduling conflicts promptly, minimizing disruptions to daily operations.
- Streamlined communication between departments by serving as a liaison for scheduling-related inquiries and concerns.
- Coordinated surgery schedules, optimizing patient flow and resource allocation.
- Coordinated pre-surgical testing requirements to minimize delays or cancellations on the day of surgery.
- Improved accuracy in surgery scheduling, ensuring appropriate pre-operative preparations were completed.
Insurance Verification Analyst
Robert Half – Alliance RX-Walgreens Prime
Irving, TX
01.2018 - 01.2019
- Streamlined verification processes to enhance efficiency and reduce turnaround times
- Analyzed claims data to identify trends, improving accuracy of submissions
- Ensured compliance with HIPAA regulations while managing sensitive patient information during the verification process.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Assisted with insurance verification and billing tasks, ensuring timely reimbursements and minimizing errors.
- Analyzed complex insurance policies to determine eligibility and benefits for patients.
- Coordinated insurance verification processes, ensuring timely and accurate patient coverage confirmation.
Claim Liaison
Claimassist LLC
Arlington, TX
01.2012 - 01.2018
- Assisted Attorney’s with negations for settlement offers.
- Analyze trends in claims processing issues and assist in identifying and quantifying issues and reviewing work processes.
- Process daily reporting files for general liability and motor vehicle claims.
- Assisted in the preparation of documents for submission for settlement offers.
- Coordinated with various departments within the organization to resolve complex claims issues.
- Conducted research into specific cases, including gathering additional information as needed from clients and other parties involved in a claim.
Benefits Specialist
Dallas City Hall
Dallas, TX
01.2011 - 01.2011
- Analyze employee benefits data to ensure accuracy, including service from third party vendors.
- Maintain and assist retiree benefit records and procedures for administration process.
- Participate in preparation and communication to employees about benefit program, procedure, claims, and any other government-mandated disclosures.
- Processed benefit enrollment forms, changes, and terminations.
- EPIC Certified
Medical Eligibility Specialist
Texas Health and Human Services
Arlington, TX
01.2009 - 01.2009
- Process eligibility forms for services including Medicaid, SNAP, and TANF.
- Prepare case reports and demographic change report.
- Conduct interviews and screenings for Medicaid applicants.
- Review and analyze applicant’s financial information against third-party sources such as employers, banks or government agencies.
Education
Medical Billing and Coding Certification -
Certified Training Institute
Arlington, TXHigh School Diploma - undefined
Broad Ripple High School
Indianapolis, INSkills
- EPIC Certified
- Pre-authorization management
- Teamwork and collaboration
- Time management
- Attention to detail
- Effective communication
- HIPAA compliance
- Compliance adherence
Timeline
Surgery Scheduling Coordinator – Vascular Surgery
Texas Health Resources
01.2019 - 12.2025
Insurance Verification Analyst
Robert Half – Alliance RX-Walgreens Prime
01.2018 - 01.2019
Claim Liaison
Claimassist LLC
01.2012 - 01.2018
Benefits Specialist
Dallas City Hall
01.2011 - 01.2011
Medical Eligibility Specialist
Texas Health and Human Services
01.2009 - 01.2009
High School Diploma - undefined
Broad Ripple High School
Medical Billing and Coding Certification -
Certified Training Institute