Tyrone Little
Clayton,NC
Summary
Revenue cycle expert with strong background in optimizing financial operations. Skilled in billing, coding, and account reconciliation while enhancing patient satisfaction. Known for fostering collaborative team environments and driving measurable outcomes. Adaptable to evolving industry demands and consistently reliable in delivering results.
Overview
17
17
years of professional experience
Work History
INSURANCE COORDINATOR & BILLING SPECIALIST
NORTH CAROLINA CENTRAL UNIVERSITY
02.2015 - Current
- Manages the University's Mandatory Health Insurance enrollment and waiver process
- Contact insurance companies to check on the status of claim payments and submit appeals for denial of claims
- Verify the accuracy of billing data and revise any errors
- Review insurance policy to determine coverage
- Resolve or clarify codes or diagnoses with conflicting, missing, or unclear information by consulting with doctors or by participating in the team's regular meetings
- Post medical insurance billings
- Research and solve claim and billing issues
- Reconcile patient accounts in a timely manner
- Retrieve patient medical records for physicians, technicians, or other medical personnel
- Maintain medical records and immunization compliance
- Reconciled accounts receivable to general ledger.
- Generated monthly billing and posting reports for management review.
- Audited and corrected billing and posting documents for accuracy.
- Handled account payments and provided information regarding outstanding balances.
- Maintained up-to-date knowledge of billing regulations and compliance requirements, ensuring adherence to legal standards.
- Proactively addressed potential billing discrepancies by conducting pre-billing audits.
- Played key role in annual audit process by providing comprehensive billing records and explanations for variances.
- Collaborated with healthcare team to ensure billing codes were accurately applied, optimizing reimbursement from insurance companies.
- Negotiated with insurance companies to resolve disputed claims, securing rightful payments.
- Reduced billing errors, leading to decrease in customer complaints, by conducting regular audits of billing data.
- Increased revenue retention by setting up follow-up system for outstanding payments.
- Enhanced accuracy in patient billing through meticulous record-keeping and verification of insurance details.
- Maximized revenue potential by identifying and resolving under-billed accounts.
COVID-19 TESTING COORDINATOR
NORTH CAROLINA CENTRAL UNIVERSITY
08.2021 - 12.2023
- Provides testing strategy, schedule coordination, compliance, and audit of all students under the testing protocols which includes molecular and antigen testing for entry, surveillance, special populations, symptomatic, and close contact individuals.
- Reporting student positive test results ranging from 10 to 20 per day and contact tracing notifications.
- Coordinates with the Quarantine & Isolation unit of student movement.
- Enhanced testing efficiency by streamlining test coordination processes and procedures.
- Coordinated cross-functional teams for efficient collaboration during the entire testing process.
- Drafted reports to detail findings from testing phases.
- Assisted in the development of robust test plans, incorporating best practices for maximum effectiveness for the entire campus community.
HEALTH SERVICE SPECIALIST
CIGNA HEALTH MANAGEMENT INC
09.2008 - 10.2014
- Facilitated approximately 60 requests for prior authorization of inpatient and outpatient services per day
- Collected and provided medical documentation for case management and medical review
- Reviewed medical records and clinical information for retrospective medical necessity review
- Provided accurate information to medical providers based on an understanding of Customer and service requirements
- Managed medical records with accuracy and confidentiality, ensuring compliance with HIPAA regulations.
- Advocated for patients'' rights within the healthcare system, working closely with insurance companies to secure coverage for necessary treatments or procedures.
- Maintained up-to-date knowledge of healthcare industry trends and advancements, applying new strategies to continuously improve patient care quality.
Education
Bachelor of Science - Psychology
NORTH CAROLINA CENTRAL UNIVERSITY
Durham, North Carolina12.2020
Skills
- Medical terminology
- Coding
- HIPAA compliant
- Insurance claims processing
- Insurance verification
- Claims processing
- Strategic thinking skills
- Accounts receivable
- Revenue cycle management
- Records management
- Billing software
- Excellent communication
- Organizational skills
- Effective communication
Awards
2020-2021 Division of Student Affairs Outstanding Professional
Timeline
COVID-19 TESTING COORDINATOR
NORTH CAROLINA CENTRAL UNIVERSITY
08.2021 - 12.2023
INSURANCE COORDINATOR & BILLING SPECIALIST
NORTH CAROLINA CENTRAL UNIVERSITY
02.2015 - Current
HEALTH SERVICE SPECIALIST
CIGNA HEALTH MANAGEMENT INC
09.2008 - 10.2014
Bachelor of Science - Psychology
NORTH CAROLINA CENTRAL UNIVERSITY
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