Tyneika Roberts
Orlando,FL
Summary
Successful at efficiently handling client inquiries, billing and administrative tasks. Familiar with contracts and other documents affecting billing processes. Knowledgeable about preparing invoices, processing payments and pursuing past-due balances. Team-oriented, dependable and performance-driven. Organized and dependable candidate Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
9
9
years of professional experience
Work History
Clinical Operations Representative
TurninPoint Healthcare
11.2022 - Current
- Enter and process requests in an efficient and accurate manner
- Verify and update critical data impacting downstream workflows
- Review and maintain service request and call center database for completeness of information
- Review portal system usability and ease of navigation; assists with testing and support
- Perform outbound calls to members, providers and clients, as required
- Provided feedback and recommendations on workflow and database needs to improve quality and processing times, including modifications to provider portal, web design and back-end information.
- Exceeded performance targets through diligent work ethic and focus on results-driven tasks.
- Understood each target customer's business model, mapped out organization, and identified unique technology needs.
Customer Service Representative
Mphasis
09.2022 - 11.2022
- Educated customers and providers about billing, payment processing and support policies and procedures
- Provide updates to providers regarding claim status
- Handled account payments and provided information regarding outstanding balances
- Kept vendor files accurate and up-to-date to expedite payment processing
- Verified client information by analyzing existing evidence on file
- Contact insurance carriers to discuss policies and individual patient benefits
- Maintained confidentiality of patient finances, records and health statuses
- Coordinated with contracting department to resolve payer issues.
Billing Coordinator
Carepath Rx
11.2021 - 04.2022
- Review rejected claims due to diagnosis or insurance issues
- Generate home Infusion claims for submissions to patients and/or third-party payers and commercial insurances to obtain timely and accurate payments
- Communicated with insurance providers to resolve denied claims and resubmit
- Prepared billing statements and verified correct diagnostic coding for accuracy and completeness
- Reviewed patient records, identified medical codes and created invoices for billing purposes
- Ensure all documentation is filed and authorization are approved for patient's services
- Updated documentation, reports and spreadsheets with financial information.
Accounts Payable / Billing Clerk
Southeast Medical Services
07.2018 - 11.2021
- Work closely with referral source, injured worker, and DME provider to ensure appropriate DME is delivered within a specified time frame
- Negotiate pricing with vendors that is not in network and review contracts for vendors that's in network
- Prepared vendor invoices and processed incoming payments
- Applied proper codes to invoices, files and receipts to keep records organized and easily searchable
- Reviewed vendor invoices for appropriate documentation and validity prior to payment
- Responded to inbound inquiries regarding accounts and payments
- Matched purchase orders with invoices and recorded necessary information
- Generated invoices upon receipt of billing information and tracked collection progress
- Maintained good working relationships with vendors and resolved disputes
- Processed payment via telephone and in person with focus on accuracy and efficiency.
Customer Service Support
Rotech Oxygen & Medical Equipment
08.2016 - 04.2018
- Processes new orders, responds to questions, resolves issues or forwards to appropriate personnel in a timely manner to ensure patient and referral satisfaction
- Provides thorough review and Quality Assurance for medical necessity and documentation requirements
- Provides education to referral sources and patients on qualifications for service and 3rd party billing
- Conducts insurance verification and eligibility for services/products
- Obtains authorization and qualification documentation
- Processes work orders to field locations and coordinates timely fulfillment of products and services ordered
- Communicates with patients and referral sources both verbally and in writing to ensure questions and concerns are processed in a timely manner.
Patient Care Advocate
Express Scripts
01.2016 - 06.2016
- Effectively managed a high volume of inbound and outbound member, provider and physician calls with friendly demeanor and full knowledge of billing department processes
- Answer questions related to pharmacy benefits, while maintaining productivity standards and performance
- Upheld confidentiality requirements and regulatory compliance guidelines
- Verified insurance and communicated coverage to staff and patients
- Verified client information by analyzing existing evidence on file
- Obtained data such as patient, insurance ID, insurance provider and medical codes to properly file insurance claims
- Review patient's account to assure payers are loaded correctly by review/verify patient's eligibility and insurance verification.
Education
Associate of Applied Science - Health Information Management
Ultimate Medical Academy - Clearwater
Clearwater, FL10.2024
High School Diploma -
Mid-Florida Tech
Orlando, FL05.2012
Skills
- ICD-10, CPT and HCPC coding
- EMR/ EHR Systems
- Correcting Submissions
- Accounts Payable and Receivable
- Billing
- Electronic Invoicing
- Excellent Communication
- Analytical and Critical Thinking
- Self-Motivated
- Attention to Detail
- Problem-Solving
- Documentation Review
- Documentation processing
- Data Entry
Personal Information
Work Permit: Authorized to work in the US for any employer
Timeline
Clinical Operations Representative
TurninPoint Healthcare
11.2022 - Current
Customer Service Representative
Mphasis
09.2022 - 11.2022
Billing Coordinator
Carepath Rx
11.2021 - 04.2022
Accounts Payable / Billing Clerk
Southeast Medical Services
07.2018 - 11.2021
Customer Service Support
Rotech Oxygen & Medical Equipment
08.2016 - 04.2018
Patient Care Advocate
Express Scripts
01.2016 - 06.2016
Associate of Applied Science - Health Information Management
Ultimate Medical Academy - Clearwater
High School Diploma -
Mid-Florida Tech
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