Summary
Overview
Work History
Education
Skills
Timeline
Generic

TOSHA FRANKLIN

ROSENBERG,TX

Summary

Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.

Overview

4
4
years of professional experience

Work History

SR CLINICAL ADMIN COORDINATOR

OPTUM SERVICES INC
08.2021 - Current
  • Built strong relationships with patients and families for optimized care satisfaction.
  • Coordinated, monitored, assigned, and documented patient and clinical care activities.
  • Work with market providers and clinical team to ensure members health, safety and welfare and maintain compliance with Medicare guidelines.

Senior Patient Access Representative

Conifer Health Solutions, Value-Based Care
10.2019 - 08.2021
    • Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
    • Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
    • Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
    • Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
    • Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
    • Trained new staff on hospital processes and procedures.
    • Verified patient insurance eligibility and entered patient information into system.
    • Trained new staff on filing, phone etiquette and other office duties.

Patient Account Representative

Aveanna Healthcare
05.2019 - 10.2019
    • Contacted patients after insurance was calculated to obtain payments.
    • Electronically submitted bills according to compliance guidelines.
    • Monitored flags and resolved urgent items with accuracy and efficiency.
    • Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
    • Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
    • Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.

Education

No Degree - Medical Assisting Administrative

Unitech Training Academy - Lafayette
Alexandria, LA
06.2011

GED -

University of Houston - Downtown
Houston, TX
03.1997

Skills

    • Data Entry
    • Database Management
    • Information Collection
    • Consulting
      • Administrative Leadership
      • Customer Service
      • MS Office
      • Insurance Verification

Timeline

SR CLINICAL ADMIN COORDINATOR

OPTUM SERVICES INC
08.2021 - Current

Senior Patient Access Representative

Conifer Health Solutions, Value-Based Care
10.2019 - 08.2021

Patient Account Representative

Aveanna Healthcare
05.2019 - 10.2019

No Degree - Medical Assisting Administrative

Unitech Training Academy - Lafayette

GED -

University of Houston - Downtown

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TOSHA FRANKLIN