Tracie Thomure

Increased efficiency in case management tasks by promptly obtaining relevant information from healthcare providers for timely assessments and decisions on care plans.

• Contributed to efficient department operations by maintaining organized files and record-keeping systems for easy access and retrieval.
• Streamlined data entry processes, ensuring timely submission of all required documentation for utilization review activities.
• Boosted accuracy in clinical decision-making by providing detailed analysis of medical records for physicians and nursing staff involved in utilization review processes.
• Reduced instances of denied claims due to insufficient documentation by meticulously verifying the accuracy of all submitted materials during the utilization review process.
• Obtained authorizations from multiple insurance carriers for various levels of care.
• Performed prior authorization review of services requiring notification.
• Upheld HIPAA regulations and standards for protecting patient information.
• Retrieved medical data for physicians and patients.
• Secured confidential patient information from unauthorized access.
• Coded and abstracted medical records according to ICD-10-CM and CPT coding guidelines.
• Studied and researched various medical terms as well as software and coding systems.