TRACEY TUNSTALL
IL
Summary
An experienced healthcare Manager with ensuring high standards of culturally competent care for a wide variety of patients with diverse needs. With over 18 years' experience in healthcare and with experience comes leadership, value, integrity, dedication and compassion for those being served.
Overview
20
20
years of professional experience
Work History
Manager, Insurance Coordination
Fresenius Medical Care
Bolingbrook, Illinois
11.2018 - Current
- Directly Manage a team of 8 Insurance Coordinator Supervisors in Midwest and Great Plains areas. Also indirectly manage a total of 65 employees throughout the region
- Provides guidance, direction, training, and support to Insurance Coordinator Supervisors as well as Insurance Coordinators to ensure they are meeting the needs of the patients they serve and demonstrate insurance awareness of the issues in the areas in which they work.
- Reviews and audits Insurance Coordinator Supervisors data base reports to ensure compliance and productivity and that they are holding their teams accountable for caseloads that they manage.
- Review weekly/monthly reports submitted by Insurance Coordinator Supervisors and Insurance Coordinators to ensure patients are receiving education, proper insurance enrollment, and assistance needed to secure optimal insurance coverage, AKF assistance, and/or Indigent waiver approval as necessary.
- Compiles monthly reports from Insurance Coordinator team for compilation in Division monthly reports.
- Provides day to day guidance, training and assistance to assigned Supervisors and Insurance Coordinators as part of continued career development and advancement within the organization.
- Closely monitors - providing support and guidance to - new Insurance Coordinators after initial training.
- Address identified performance issues with Insurance Coordinator Supervisors and provide a plan of action and additional training to ensure Insurance Coordinator Supervisors are meeting expectations of the position. If consistent performance issues are identified, implements developmental action plans as appropriate.
- Provides input and action plans regarding hiring, firing and disciplinary actions pertaining to assigned Insurance Coordinator Supervisors and Insurance Coordinators, organizing and conducting initial interviews for new hires and promotions.
- Provides guidance and direction to ensure Insurance Coordinator, Supervisor and patient success during annual Open Enrollment.
- Provides direction and input to CM, DO and area RVP to minimize self pays and maintain commercial insurances.
- Review performance data to monitor and measure productivity, goal progress and activity levels.
- Evaluate employees' strengths and assigned tasks based upon experience and training.
- Compile data highlighting key metrics to report information, determine trends and identify methods for improving healthcare results.
- Achieve or exceeded financial goals under my direction top performing coordinators were able to assist more than 900 patients in obtaining coverage during the ACA annual Open Enrollment.
- Respond to patient calls swiftly to resolve issues and answer questions.
- Approve regular payroll submissions for employees through Kronos.
- Onboard new employees with training and new hire documentation through WorkDay..
- Other Assigned Duties
Insurance Coordinator Supervisor
Fresenius Kidney Care
Elk Grove Village, IL
06.2017 - 11.2018
- Supervises a team of 8 Insurance Coordinators for Chicago, West Chicago, Central IL, Iowa and Indiana
- Reviews and audits Insurance Coordinator's data base reports to ensure compliance and productivity.
- Provides counseling and additional training to team members as necessary.
- Provides IC Manager and Division management with documentation and follow-up for all patients categorized on status reports.
- Monitors the accuracy and completion of progress notes providing guidance to IC as necessary.
- Compiles monthly reports from Insurance Coordinator team for compilation in Division monthly reports.
- Provides day to day guidance, training and assistance to assigned Insurance Coordinators as part of continued career development and advancement within the organization.
- Closely monitors - providing support and guidance to - new Insurance Coordinators after initial training.
- Any other duties as assigned by management.
Insurance Coordinator
Fresenius Medical Care
Chicago, IL
04.2016 - 06.2017
- Explores, recommends, and coordinates the varied financial assistance options available to kidney dialysis patients in order to ensure the provision of the best financial resources possible for each patient in the assigned clinics, while maximizing revenue for the company.
- Maintained a caseload of 1000 patients.
- Meet with patients at their assigned clinics to educate on insurance options.
- Obtain signatures and premium statements from patients. Discuss insurance options when policies are close to/or will terminate. Determine Medicare/Medicaid Eligibility, assist with re-determinations, reinstatements and track COB for patient's on EGHP plans.
- Collect financial information to determine if premium assistance is needed, such as completing charitable assistance applications, visit assigned clinics as needed to meet with patients to identify, address, research and resolve insurance coverage issues.
- Assist patient's with IW's as necessary. Prepare monthly clinic reports that include all insurance and any issues that may arise.
- Send monthly reports to designated clinics, supervisors and managers. Review weekly admissions report, monitor self pays and open worklist items that may need to be closed.
- Cover other clinics as needed.
Case Manager
Centene Corporation
Chicago, IL
01.2015 - 03.2016
- Provided support to families through education on procedures, regimens,prevention and care.
- Patient Care- Ensured quality control through admissions, assessment,treatment and referral for a broad range of patients.
- Educational Plans Developed course plans aimed at meeting academic, intellectual and social needs of each student.
- Supported classroom teacher in implementing a developmentally appropriate curriculum for a group of students.
- Reporting Prepared regular charts on patients' health related history, medication restrictions and allergies.
- Quality Assurance
- Ensured and enforced medical office compliance with HIPAA and PHI regulations for maximum quality and control.
Account Analyst
Conifer Health Solutions
Westchester, IL
09.2005 - 0 2015
- Analyzing accounts for same day surgery, inpatient admissions, outpatient diagnostic testing and emergency room.
- Maintained accurate and prompt verification of eligibility and benefits and gathered authorizations for diagnostic testing, clinic, surgeries and admissions from different insurance companies.
- Secured referrals, RQI's and authorizations for services when appropriate. Collections as appropriate from patients and payors for services rendered.
- Obtained MR (Medical Records) for patient and physician investigation.
- Helped resolve any patient issues with quality of care while Inpatient, ER, and Outpatient services.
- Maintained best practices to improve quality of care for all patient's served.
- Trained new staff to learn hospital program used for registration, Medical Records and verification process.
- Reviewed electronic medical records for any services where payment was denied by payor.
- Investigated denials and made appropriate corrections for re-submission to insurance companies for prompt payment.
- Documented patient information obtained from interviews.
Front Desk Supervisor
Residence Inn
Bloomingdale, IL
10.2003 - 10.2005
- Greeted, registered and assigned rooms to guests of hotel Posted charges for rooms, food, or telephone calls to ledgers manually or by using computers.
- Made and confirmed reservations.
- Assisted General Manager with scheduling for front desk Completed daily room reports for accuracy and charges.
- Night auditing
Education
Master of Arts - Human Resources Management
Concordia University, St. Paul
Saint Paul, MN10.2020
Master - Psychology
Grand Canyon University
Phoenix, AZ07.2017
BS - Educational Studies
Grand Canyon University
Phoenix, AZ12.2014
Skills
- Case management
- Intakes and assessments
- Medicaid/Medicare understanding
- Managerial background
- Quality Improvement
- Account Analyst
- Medical Insurance Expert
- Critical Thinking
- Employee Recruitment and Hiring
- Employee Performance Evaluations
- Performance Monitoring
- Human Resources Management
Timeline
Manager, Insurance Coordination
Fresenius Medical Care
11.2018 - Current
Insurance Coordinator Supervisor
Fresenius Kidney Care
06.2017 - 11.2018
Insurance Coordinator
Fresenius Medical Care
04.2016 - 06.2017
Case Manager
Centene Corporation
01.2015 - 03.2016
Account Analyst
Conifer Health Solutions
09.2005 - 0 2015
Front Desk Supervisor
Residence Inn
10.2003 - 10.2005
Master of Arts - Human Resources Management
Concordia University, St. Paul
Master - Psychology
Grand Canyon University
BS - Educational Studies
Grand Canyon University
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