TRACEY STAFFORD
Tallahassee,FL
Summary
Healthcare Revenue Cycle Specialist experienced in medical billing, accounts receivable, and claims management. Achieved improved revenue cycle performance and compliance through problem-solving skills and attention to detail. Finance professional streamlined payment processes and resolved discrepancies, contributing to accurate financial management and operational efficiency.
Overview
1
1
Certification
31
31
years of professional experience
Work History
Accounts Receivable Specialist – Revenue Cycle Functions
Red Hills Surgical Center
11.2014 - 04.2026
- Managed full revenue cycle operations including insurance verification, charge entry, claims processing, payment posting, account reconciliation, and reimbursement review.
- Worked extensively with Medicare, Medicaid, BCBS, Aetna, TRICARE, Sunshine Health, Workers' Compensation, Vocational Rehabilitation, and commercial insurance plans.
- Resolved complex claim denials, payment discrepancies, and reimbursement issues through detailed research, appeals, and payer follow-up.
- Reviewed EOBs and ERAs to identify payment variances, coding issues, and underpayments, enhancing reimbursement accuracy.
- Maintained aging accounts receivable and executed follow-up activities to maximize collections and minimize outstanding balances.
- Provided payer-specific guidance regarding eligibility, benefits, authorization requirements, and reimbursement policies.
- Delivered payer-specific guidance on eligibility, benefits, authorization requirements, and reimbursement policies to facilitate accurate claim processing.
- Assisted with workflow improvements, cross-training, and operational support during staffing transitions and process changes.
Insurance Verifier
Tallahassee Outpatient Surgery Center
02.2008 - 10.2014
- Verified benefits, eligibility, and coverage to ensure compliance with insurance requirements, facilitating prior authorizations and payment reconciliation for seamless claims processing.
- Verified insurance eligibility and benefits for surgical procedures, ensuring accurate patient information.
- Collaborated with medical staff to resolve billing discrepancies and improve patient service experiences.
- Implemented streamlined processes for verification workflows, enhancing efficiency and reducing errors.
Insurance Billing Clerk
Medical Group of North Florida
01.2007 - 01.2008
- Executed billing, conducted AR follow-up, posted payments, and researched denials to ensure accurate revenue collection.
- Processed insurance claims to ensure timely reimbursement and accurate records.
- Coordinated with healthcare providers to resolve billing discrepancies and improve customer satisfaction.
- Managed patient accounts, verifying insurance coverage and eligibility efficiently.
Rehabilitation Manager
TMH Outpatient Rehab
01.2001 - 01.2007
- Coordinated office workflow, conducted staff evaluations, managed scheduling, and ensured documentation accuracy.
- Led interdisciplinary team to develop and implement rehabilitation programs for diverse patient needs.
- Oversaw compliance with regulatory standards and best practices in outpatient rehabilitation services.
- Implemented quality improvement initiatives to enhance patient care and optimize operational efficiency.
Accounts Manager
TMH Home Health
01.1995 - 01.2001
- Managed accounts receivable operations, billing workflows, and documentation compliance.
- Led financial reporting and analysis to ensure compliance with healthcare regulations.
- Developed budgets and forecasts, aligning departmental goals with organizational objectives.
- Managed accounts receivable and payable processes, enhancing cash flow management strategies.
Education
High School Diploma -
Leon High
Tallahassee, FL05.1988
Skills
- Revenue Cycle
- AR/Collections
- Claims Submission
- Denial management
- Insurance Verification
- Charge Entry
- ERA/EOB Review
- Medicare
- Medicaid
- BCBS
- Aetna
- TRICARE
- Sunshine Health
- Commercial Plans
- Workers Comp
- Workflow Optimization
- HST/EMR Systems
- EMR/EHR Systems
- Clarity
- Microsoft Excel
- Microsoft Word
- Microsoft Outlook
- Problem Solving
Certification
- All Lines Insurance Adjuster License — In Progress
- Revenue Cycle Management
- Medical Billing & Collections
- Denial Management & Appeals
- Insurance Verification
- Healthcare Compliance
- Reimbursement Analysis
Timeline
Accounts Receivable Specialist – Revenue Cycle Functions
Red Hills Surgical Center
11.2014 - 04.2026
Insurance Verifier
Tallahassee Outpatient Surgery Center
02.2008 - 10.2014
Insurance Billing Clerk
Medical Group of North Florida
01.2007 - 01.2008
Rehabilitation Manager
TMH Outpatient Rehab
01.2001 - 01.2007
Accounts Manager
TMH Home Health
01.1995 - 01.2001
High School Diploma -
Leon High