Tracy Roberts

Seasoned Recovery Resolution Analyst with a proven track record at Optum, adept in medical coding and audit procedures. Excels in problem-solving and teamwork, significantly enhancing operational efficiency. Demonstrates exceptional attention to detail and communication skills, ensuring accuracy in code validation and compliance with healthcare payer guidelines.

• Enhanced team performance through effective coaching, mentoring, and performance monitoring through the TPR/SSE Pilot Program.
• Supported colleagues during busy periods, demonstrating strong teamwork abilities and adaptability skills.
• Demonstrated adaptability to different medical specialties, broadening knowledge and expertise in various disciplines.
• Assumed additional responsibilities as needed, demonstrating adaptability and commitment to job excellence.
• Followed established auditing processes to meet internal and regulatory requirements.
• Contributed to cost savings by identifying areas of potential over-billing in medical claims processing.
• Conducted comprehensive chart reviews to validate coding accuracy, ensuring proper reimbursement for services rendered.
• Maintained an up-to-date understanding of evolving healthcare regulations by engaging in continuous professional development opportunities.
• Kept current with industry advancements through continuing education courses and professional development opportunities.

Recovery Resolution Analyst with a proven track record at Insight Global. Demonstrates exceptional attention to detail and communication skills, ensuring accuracy in code validation and compliance with healthcare payer guidelines.

• Contributed to cost savings by identifying areas of potential over-billing in medical claims processing.
• Conducted comprehensive chart reviews to validate coding accuracy, ensuring proper reimbursement for services rendered.
• Maintained an up-to-date understanding of evolving healthcare regulations by engaging in continuous professional development opportunities.
• Kept current with industry advancements through continuing education courses and professional development opportunities.

• Audited on average 70 to 90 cases per day with 95% accuracy.
• Provided detailed documentation on audit findings, facilitating swift corrective action when necessary.
• Maintained confidentiality, handling sensitive information discreetly throughout all stages of the audit process.
• Ensured compliance with regulatory requirements by performing regular audits and staying up-to-date on industry standards.
• Mentored junior auditors, sharing knowledge and best practices to foster their professional growth within team.
• Performed observations and evaluated supporting documents to supplement audit findings.
• Adapted plans and schedules to meet changing priorities of work objectives, resources and workload demands.

• Audited 70 to 90 cases per day with 95% accuracy.
• Provided detailed documentation on audit findings, facilitating swift corrective action when necessary.
• Maintained confidentiality, handling sensitive information discreetly throughout all stages of the audit process.
• Ensured compliance with regulatory requirements by performing regular audits and staying up-to-date on industry standards.
• Mentored junior auditors, sharing knowledge and best practices to foster their professional growth within the team.
• Followed established auditing processes to meet internal and regulatory requirements.

• Followed up on unpaid insurance claims, outstanding customer balances and other financial discrepancies.
• Assisted in training new staff members on office procedures, fostering a supportive work environment.
• Attended continuing education seminars, staying up-to-date on industry advancements and best practices for optometry technicians.
• Improved patient satisfaction by providing thorough pre-testing and efficient optical services.
• Streamlined office operations by managing appointment scheduling and updating patient records.
• Completed insurance claim forms accurately, expediting reimbursements for both patients and the practice.
• Maintained patient confidentiality at all times, adhering to HIPAA regulations and safeguarding sensitive medical information.
• Assisted ophthalmologists in performing diagnostic tests, ensuring accurate measurements and data collection.
• Collaborated effectively with staff members across various departments to ensure seamless delivery of quality patient care services.
• Contributed to the practice''s growth by actively participating in marketing initiatives and community outreach events.
• Provided patients with detailed instructions for pre- and post-op care under physician supervision to promote healing and optimal recovery strategies.
• Reviewed vendor invoices for appropriate documentation and validity prior to payment.
• Applied proper codes to invoices, files, and receipts to keep records organized and easily searchable.