Tynisha Hall
Albany,Georgia
Summary
Results-oriented healthcare professional with extensive experience at Phoebe Healthcare System, known for leveraging data-driven insights to solve complex problems and enhance team performance. Achieved a 97% accuracy rating in patient access, leading to significant improvements in operational efficiencies. Expertise in advanced technical solutions positions this candidate to deliver innovative strategies within clinical research environments.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Care Management Representative / Claim Examiner
Phoebe Healthcare System
Albany
01.2024 - Current
- Determines covered insurance losses by studying provisions of a policy or certificate
- Establishes proof of loss by studying documentation and assembling additional information from outside sources
- Documents specific claims by completing and recording forms, reports, logs, and records
- Analyzes insurance claims to prevent fraud
- Prepares reports by collecting, analyzing, and summarizing information
- Resolves claims by approving or denying documentation, calculating benefits due, and determining compensation settlement
- Ensures legal compliance by following company policies, procedures, and guidelines, as well as state and federal insurance regulations
Phoebe Emergency Center Registration (PRN)
Phoebe Putney Memorial Hospital
Albany, Georgia
01.2020 - Current
- Coordinate with various monitors and sponsors to ensure optimum database performance and reporting, as well as compliance, is being met and applicable to regulatory documentation, leading to insurance verification
- Extensively performs administrative functions to ensure the department operates according to policies, procedures, and protocols; ensures that all cases are entered accurately and thoroughly into the admissions, discharge, transfer, and billing system
- Provides customer service and status updates in the waiting room, in-room, and before patient departure; requests payment and provides payment plan information for patient account balances when necessary.; obtains signed statements from patients to protect the hospital's interests; and accepts and stores patient valuables when necessary
- Manage the verification and eligibility of insurance benefits; enter patient information and route completed paperwork to the appropriate department
Travel Quality Assurance Specialist (remote)
Care Access
Boston, Massachusetts
01.2023 - 01.2024
- Conducted regular audits and assessments of processes, documents, and interactions to ensure both site and coordinators meet the established quality standards which may involve reviewing medical records, and communication that has been documented between patient and coordinator
- Validated the accuracy of documentation, including patient records, reports, and other healthcare-related documents, to ensure compliance with quality requirements; provided direct constructive feedback and Coaching team members, including medical professionals, administrative staff, and customer service representatives, to help them improve their performance and maintain the desired quality standards
- Managed comprehensive records of quality assessments, audit findings, and improvement initiatives
- Regularly report on quality performance to management and stakeholders; identify potential risks and areas of vulnerability in the quality assurance process, and work on strategies to mitigate these risks to avoid issues and maintain compliance
- Investigate variances and potential risk issues, performing root-cause analysis where appropriate
- Ensure that all variances are documented and investigated within the established time frame as well as preparation of reports and identifiable trends
Vendor Management / Procurement Specialist (remote)
Elligo Health Research
Quincy, Massachusetts
01.2022 - 01.2023
- Perform buying duties for all clinical research departments, including meeting with suppliers and preparing contract negotiations
- Compared invoices, and ran concurrent invoice records, resulting in a 62% reduction in errors
- Analyze vendor proposals and bids, evaluating proposals against established criteria to make informed decisions regarding partnerships; coordinate with finance and procurement departments to manage vendor contracts, invoices, and payments, ensuring accuracy and adherence to budgetary guidelines
- Identify opportunities for cost savings, process improvements, and efficiencies within the vendor management framework; work closely with finance and accounting departments to ensure accuracy in billing, invoice reconciliation, and budget compliance
Travel Clinical Trial Coordinator (remote)
Elligo Health Research
Quincy, Massachusetts
01.2022 - 12.2022
- Responsible for conducting day-to-day execution of clinical research protocols including obtaining informed consent, completing study procedures, dispensing, accounting for study drugs, and documenting drug compliance
- Developed patient education programs and tools; followed patients throughout the care continuum, including inpatient admissions, and collaborated with inpatient care management resources; delivered quarterly report cards to Virtual committees and other groups which demonstrated outcomes and performance improvement activities
- Accurately updating and maintaining regulatory documentation, upheld accuracy with study binders and updates with IRB
- Responsible for clinical communication with central and local IRB and maintaining ethical approval for studies, from initial study approval through study amendments, annual contribution, and final termination
Clinical Trial Navigator
Javara Research
Albany, Georgia
01.2020 - 12.2022
- Developed, initiated, and supported clinical studies under the supervision of principal investigators
- Served as an essential link between patients and all other care providers; facilitated appointments for consultants and support services within established service standards, including social workers, dietitians, and physicians; utilized knowledge of services and key contacts for all administrative departments and research and hospital practices to facilitate the conduct of high quality, efficient research activities
- Responsible for database entry of human tissue samples, including daily, weekly, and monthly intake, processing, diagnostic, and sample retrieval
- Responsible for recruiting and screening prospective subjects for clinical trials
- Documented and conducted appropriate correspondence regarding adverse events, in multiple adverse events
Research Data Regulatory Coordinator/ Clinical Research
Phoebe Putney Memorial Hospital
Albany, Georgia
01.2016 - 12.2020
- Screened patient records, databases, and physician referrals to identify prospective candidates for research studies
- Responsible for completing and submitting required regulatory documents including CRFs and SAEs
- Effectively coordinated patient treatments, follow-up visits, radiology, and lab tests and stayed within the guidelines of protocol compliance
- Collaborated weekly with investigators to recruit eligible subjects to clinical protocols; facilitated and oversaw research studies by preparing regulatory documents for submission to the Institutional Review Board (IRB)
- Serve as a liaison for both the IRB and the Clinical Research department to assist with managing the workflow between the study sponsor, government agencies, monitors, data-entry operators, and clinical data coordinator
- Key performer for having maintained 97% accuracy rating accuracy for patient access for six consecutive months
Education
Master of Business Administration (MBA) - Healthcare Management
Albany State University
Albany, Georgia11.2024
Bachelor of Science (BS) - Organizational Leadership
Albany State University
Albany, Georgia12.2023
Skills
- Visionary Strategy
- Data-Driven Problem-Solving
- Concise Messaging
- Effective Team Collaboration
- Efficient Task Organization
- Administrative Support
- Data Transformation
- Strategic Leadership
- Curriculum Development
- Effective Project Coordination
- Quantitative Assessment
- Information Gathering
- Information Management
- Oncology Expertise
- Inoculation Procedures Knowledge
- Diabetes Management
- Proficient in Medical Devices
- Early Stage Clinical Trials
- Phase 2 Trial Management
- Advanced Technical Knowledge
Certification
- Project Management Certification, 05/16, Emory University, Atlanta, Georgia
- Six Sigma Green Belt, 02/11, Villanova University, Philadelphia, Pennsylvania
Therapeuticareas
- Oncology
- Vaccination
- Diabetes
- Medical devices
- Phase 1 and Phase 2 of clinical trial
References
References available upon request.
Timeline
Care Management Representative / Claim Examiner
Phoebe Healthcare System
01.2024 - Current
Travel Quality Assurance Specialist (remote)
Care Access
01.2023 - 01.2024
Vendor Management / Procurement Specialist (remote)
Elligo Health Research
01.2022 - 01.2023
Travel Clinical Trial Coordinator (remote)
Elligo Health Research
01.2022 - 12.2022
Phoebe Emergency Center Registration (PRN)
Phoebe Putney Memorial Hospital
01.2020 - Current
Clinical Trial Navigator
Javara Research
01.2020 - 12.2022
Research Data Regulatory Coordinator/ Clinical Research
Phoebe Putney Memorial Hospital
01.2016 - 12.2020
Master of Business Administration (MBA) - Healthcare Management
Albany State University
Bachelor of Science (BS) - Organizational Leadership
Albany State University
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