Tyrone Little
Raleigh,NC
Summary
Results-driven healthcare revenue cycle and financial operations professional with 15+ years of experience overseeing billing operations, claims resolution, reimbursement analysis, compliance auditing, and revenue integrity initiatives within healthcare and higher education environments. Proven expertise monitoring revenue cycle performance metrics, reducing claim denials, reconciling accounts, and improving reimbursement workflows through data-driven analysis and process improvement strategies. Skilled in collaborating with clinical, billing, finance, and IT teams to optimize operational efficiency, enhance revenue retention, and ensure compliance with Medicaid, Medicare, HIPAA, and payer regulations. Proficient in Excel, financial reporting, claims analysis, and electronic health record systems.
Overview
18
18
years of professional experience
Work History
Insurance Coordinator & Billing Specialist
NORTH CAROLINA CENTRAL UNIVERSITY
02.2015 - 04.2026
- Monitored and analyzed revenue cycle activities from patient enrollment and registration through billing, reimbursement, and final payment resolution for the University’s Mandatory Student Health Insurance Program.
- Evaluated billing and reimbursement workflows to identify process improvement opportunities that strengthened revenue retention and reduced operational inefficiencies.
- Reviewed claim denials and reimbursement discrepancies, identified root causes, and coordinated corrective actions with insurance carriers, providers, and administrative staff to reduce rejections and improve collection outcomes.
- Assisted with accounts receivable backlog management by monitoring outstanding claims, following up on unpaid balances, and ensuring timely posting and reconciliation activities.
- Prepared and analyzed monthly financial, billing, reconciliation, and operational reports to support leadership decision-making and revenue forecasting initiatives.
- Utilized Excel and reporting tools to analyze revenue trends, payment activity, underpayments, denial patterns, and financial performance metrics.
- Collaborated with clinical providers, finance teams, billing staff, registration teams, and insurance carriers to resolve coding, diagnosis, documentation, and reimbursement issues affecting claims processing and payment accuracy.
- Conducted audits of billing, enrollment, and reimbursement records to ensure compliance with HIPAA regulations, payer guidelines, and institutional policies.
- Supported provider credentialing processes by preparing and submitting applications to insurance entities and regulatory organizations to maintain reimbursement eligibility and compliance standards.
- Assisted with workflow improvement initiatives and operational projects designed to strengthen billing accuracy, accountability, and revenue cycle efficiency.
- Communicated with patients and payors to resolve billing inquiries, payment discrepancies, and insurance coverage concerns.
- Maintained accurate electronic records and monitored work queues to ensure timely completion of billing and revenue-related tasks.
- Verified accuracy of accounts payable payments, minimizing payment errors and reducing check reissues through thorough review and reconciliation.
- Managed the university's student immunization compliance program by overseeing Medical Records operations, verifying health documentation, maintaining confidential electronic health records, ensuring compliance with state, university, and HIPAA requirements, and coordinating with students and campus partners to support enrollment eligibility.
COVID-19 Testing Coordinator
NORTH CAROLINA CENTRAL UNIVERSITY
08.2021 - 12.2023
- Directed operational oversight for campus-wide COVID-19 testing programs while supporting institutional compliance, reporting accuracy, and risk mitigation initiatives.
- Monitored testing data, operational metrics, and program outcomes to prepare reports and support leadership decision-making processes.
- Coordinated workflow improvements and collaborated with cross-functional teams to streamline testing operations, improve accountability, and ensure continuity of student services.
- Prepared operational and compliance reports evaluating testing effectiveness, utilization trends, and process performance.
- Assisted with project coordination, staff communication, and implementation of evolving health and compliance procedures.
Health Service Specialist
CIGNA HEALTH MANAGEMENT INC
09.2008 - 10.2014
- Processed high-volume prior authorization and claims-related requests for inpatient and outpatient healthcare services while ensuring compliance with payer regulations and medical necessity requirements.
- Reviewed medical documentation, authorization requests, and clinical records to support reimbursement determinations and utilization review processes.
- Collaborated with healthcare providers, case managers, and insurance carriers to resolve authorization, coverage, and reimbursement issues efficiently.
- Applied healthcare regulations, billing policies, and operational best practices to maintain quality standards and support process improvement initiatives.
- Maintained strict HIPAA compliance and confidentiality while managing patient, provider, and payer information.
- Assisted in resolving claim-related issues through detailed analysis, documentation review, and communication with internal and external stakeholders.
Education
Bachelor of Science - Psychology
North Carolina Central University
Durham, NC12.2020
Skills
- Revenue Cycle Management
- Claims Denial Analysis & Resolution
- CPT, ICD-10 & HCPCS Billing Review
- Accounts Receivable Reconciliation
- Financial Reporting & Revenue Analytics
- Revenue Integrity & Reimbursement Optimization
- Audit Preparation & Compliance Monitoring
- HIPAA & Payer Regulation Compliance
- Workflow Improvement & Process Optimization
- EPIC/EHR Workflow Support
- Claims Processing & Payment Resolution
- Excel Pivot Tables & Data Analysis
- Revenue Trend Analysis
- Cross-Functional Collaboration
- Budget Monitoring & Forecasting Support
- Team Training & Staff Development
- Patient & Payor Relations
- Project Coordination & Operational Leadership
- Claims management
- Patient account management
- Revenue cycle management
- Claims processing and resolution
- Accounts receivable and ledger reconciliation
- Budget monitoring and forecasting
- Financial operations and revenue management
- Risk management and compliance
- Audit preparation and documentation
- Policy analysis
- Policy interpretation and implementation
- Process improvement and operational efficiency
- Cross-functional leadership and collaboration
- Data integrity
- Insurance claims processing
- ICD-10 coding
- CPT coding
- Accounts receivable
Timeline
COVID-19 Testing Coordinator
NORTH CAROLINA CENTRAL UNIVERSITY
08.2021 - 12.2023
Insurance Coordinator & Billing Specialist
NORTH CAROLINA CENTRAL UNIVERSITY
02.2015 - 04.2026
Health Service Specialist
CIGNA HEALTH MANAGEMENT INC
09.2008 - 10.2014
Bachelor of Science - Psychology
North Carolina Central University
HONORS AND RECOGNITION
Division of Student Affairs Outstanding Professional, North Carolina Central University | 2020–2021