Tyrisha Harris
Baton Rouge,LA
Summary
Seasoned Adjuster and Financial Counselor with a proven track record in insurance claims investigation and customer service excellence. At United Health Care and BCBS of Louisiana, streamlined claims processing and enhanced policyholder satisfaction. Expert in insurance regulations and adept at team collaboration, consistently achieving high accuracy in claims adjustments.
Overview
17
17
years of professional experience
Work History
Patient Registration Coordinator II/ Remote
Tufts Medical Center
Boston, MA
11.2024 - Current
- Responsible for accurately registering patients in EMR including validating patient information, verification of insurance coverage, collection of required payments and ensuring the patient's experience is best in class. Responsible for understanding and compliance of state and federal regulations related to hospital registrations.
- Actively supports clinic, hospital and health system initiatives related to improvement in the day-to-day operations.
- Manages cash in accordance with established policies and procedures to ensure that payments are accurately credited to the patients' accounts and cash is maintained in a secure manner.
- Meets site collection goals.
- Accurately and efficiently registers patients in Epic; monitors and manages the flow of patients through the clinic utilizing initiative to ensure the patient experience is best in class.
- Monitors patient schedules and reviews accounts to determine the patient's financial responsibility on account balance and arranges payment plans to collect. Assists patients with access to government and community resources to enhance their access to health care services.
- Works closely with physicians, nurse practitioners and nursing staff to ensure that referrals to other providers/services/facilities are completed in accordance with payor requirements in a timely manner.
- Facilitates the patient's access to information including but not limited to MyChart access.
- Accurately updates patient's records as needed.
- Accurately enters and updates charges as necessary.
Adjuster
BCBS of Louisiana
Baton Rouge, US
08.2015 - 11.2022
- Review, research, and make necessary adjustments received through AR, audit, Financial Investigations, MSP, or changes in coverage on local contract (following departmental and corporate guidelines) to include recalculation of benefits to previously processed hospital, professional, major medical, Medicare claims submitted with incorrect codes or were processed incorrectly in the claims area for traditional contracts, PPO contracts, HMO/POS contracts
- Manually process claims on a daily basis that have previously gone through claim check (HST) to ensure accuracy of claims processing and customer satisfaction
- Mirror original claims to the corrected claim so they may be process in a timely manner
- Communicate with the member's home plan to adjusted incorrect codes, pricing, contact number, member's id
- Respond in a timely manner to provider questions about member's plan
Registation c
united health care
Baton Rouge, US
06.2017 - 07.2018
- Review, research, and make necessary adjustments received through AR, audit, Financial Investigations, MSP, or changes in coverage on local contract (following departmental and corporate guidelines) to include recalculation of benefits to previously processed hospital, professional, major medical, Medicare claims submitted with incorrect codes or were processed incorrectly in the claims area for traditional contracts, PPO contracts, HMO/POS contracts
- Manually process claims on a daily basis that have previously gone through claim check (HST) to ensure accuracy of claims processing and customer satisfaction
- Mirror original claims to the corrected claim so they may be process in a timely manner
- Communicate with the member's home plan to adjusted incorrect codes, pricing, contact number, member's id
- Respond in a timely manner to provider questions about member's plan
Financial Counselor
OUR LADY OF THE LAKE/LSU HEALTH
Baton Rouge, US
01.2012 - 08.2015
- Collecting on past due balances to bring account to current
- Collect on surgery, procedure
- Tracks collections accounts
- Pre reg on patient account to collect prior to visits
- CPT coding for surgery and procedure for OTH, OPH, ORAl, CT, MRI, PET scan
- Assisting with pre-authorization
- Verify Insurance Coverage
- Scan patient's information into registration system
- Manage calls and correspondence for Financial Assistance application
- Analyze and review required documentations for Financial Assistance
Patient Representative
Baton Rouge Clinic
Baton Rouge, US
01.2008 - 01.2012
- Schedule patient on a daily basis, pre reg, check patent in out of clinic visit, reschedule appointments
- Gathering all patient demographic information to input into system
- Verify insurance by calling are thought computer system
- Collect co pays, co insure and deductible and prior balances, make arraignment on past due balances that 60-120 day past due
Education
High School Diploma -
SCOTLANDVILLE MAGNET HIGH SCHOOL
Baton Rouge, LA01.2002
Skills
- Insurance regulations
- Claims investigation
- Customer service
- Insurance policy coverage expertise
- Data entry
- Estimation
- Tme management
- Team collaboration
- Attention to detail
- Claims processing
Timeline
Patient Registration Coordinator II/ Remote
Tufts Medical Center
11.2024 - Current
Registation c
united health care
06.2017 - 07.2018
Adjuster
BCBS of Louisiana
08.2015 - 11.2022
Financial Counselor
OUR LADY OF THE LAKE/LSU HEALTH
01.2012 - 08.2015
Patient Representative
Baton Rouge Clinic
01.2008 - 01.2012
High School Diploma -
SCOTLANDVILLE MAGNET HIGH SCHOOL
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