Summary
Overview
Work History
Education
Skills
Timeline
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Twanica Mason

Gurley,AL

Summary

Driven Precertiification Specialist who is results oriented and cares about patients and their care.

Overview

23
23
years of professional experience

Work History

Precertification Specialist

Huntsville Hospital System
01.2008 - Current
  • Mitigated potential delays in service delivery through proactive identification of potential roadblocks within the precertification process.
  • Reduced patient wait times for approval by diligently reviewing medical records and obtaining necessary documentation.
  • Enhanced interdepartmental collaboration through effective communication with case managers, physicians, and billing departments.
  • Nurtured strong professional relationships with insurance representatives, fostering a collaborative atmosphere during negotiations on behalf of patients.
  • Ensured smooth communication between healthcare providers, patients, and insurance companies, resulting in timely approvals and positive experiences.
  • Developed comprehensive knowledge of various insurance plans, policies, and coverage limitations to provide accurate guidance to patients and providers.
  • Contributed extensively to departmental goals through consistent achievement of individual performance benchmarks related to precertification accuracy and timeliness.
  • Conducted thorough follow-ups with insurance companies, ensuring timely receipt of authorization numbers for approved services.
  • Maintained strict adherence to HIPAA regulations by safeguarding confidential patient information during all aspects of the precertification process.
  • Boosted efficiency within the team by regularly updating coworkers on changes in insurance policies or procedural requirements affecting precertifications.
  • Mentored new hires within the department, sharing best practices for navigating complex insurance requirements and fostering a supportive team environment.
  • Minimized claim denials by accurately coding procedures according to CPT guidelines before submission for approval.
  • Increased accuracy of submitted claims through meticulous attention to detail in verifying insurance eligibility and benefits.
  • Streamlined precertification processes by implementing efficient tracking systems and prioritizing urgent cases.
  • Facilitated successful appeals for denied services by providing detailed documentation supporting medical necessity as required by insurers.
  • Analyzed trends in denials or authorization delays to identify opportunities for improvement within the precertification department.
  • Processed and certified documents for accuracy and compliance with government regulations.
  • Trained staff on current eligibility requirements and policies.
  • Engaged wider departments in accurate, timely paperwork completion.
  • Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
  • Performed various administrative tasks by filing, copying and faxing documents.
  • Answered telephone calls to offer office information, answer questions, and direct calls to staff.
  • Coordinated referrals through insurance and other medical specialists and documented details in patient charts.

Office Manager

BKM Enterprises
05.2001 - 01.2008
  • Handled sensitive information with discretion, maintaining confidentiality of company documents and personnel records.
  • Provided exceptional customer service when addressing client inquiries or concerns via phone calls or email correspondence.
  • Coordinated office events and meetings, ensuring timely execution and optimal scheduling for all participants.
  • Maintained accurate financial records by reconciling accounts payable/receivable transactions regularly to ensure balanced budgets.
  • Conducted regular inventory assessments of office supplies, ordering necessary items proactively to prevent stock shortages.
  • Developed comprehensive policy manuals outlining procedures and guidelines, contributing to a well-organized workplace culture.
  • Served as a liaison between upper management and staff members, facilitating open channels of communication to address concerns or issues promptly.
  • Enhanced team productivity by delegating tasks effectively and overseeing daily workflow.
  • Supported department heads in accomplishing their goals through diligent administrative assistance such as report generation and data entry.
  • Streamlined office operations by implementing efficient filing systems and organizational strategies.
  • Contributed to workplace safety by ensuring compliance with established emergency protocols and conducting regular equipment inspections.

Education

Engineering (Pre-Engineering)

Calhoun Community College
Tanner, AL

High School Diploma -

Madison County High School
Gurley, AL
05.1997

Skills

  • Strong Communication Skills
  • Medical Billing Familiarity
  • Professionalism and Ethics
  • Conflict resolution techniques
  • Prior Authorization Knowledge
  • Patient Confidentiality Adherence
  • HIPAA compliance awareness
  • Medical coding familiarity
  • Insurance Verification Expertise
  • Healthcare Regulations Understanding
  • Documentation and paperwork
  • Medicaid knowledge
  • Teamwork and Collaboration
  • Problem-Solving
  • Attention to Detail
  • Adaptability and Flexibility
  • Office Management
  • Self Motivation
  • Time management abilities
  • Decision-Making
  • Problem-solving aptitude
  • Reliability

Timeline

Precertification Specialist

Huntsville Hospital System
01.2008 - Current

Office Manager

BKM Enterprises
05.2001 - 01.2008

Engineering (Pre-Engineering)

Calhoun Community College

High School Diploma -

Madison County High School

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Twanica Mason