Summary
Work History
Skills
Timeline
Generic

Tamara Rainey

Pittsburgh

Summary

Dedicated healthcare professional with expertise in patient scheduling, clinical support, and population health management. Skilled in coordinating care, educating members on health plans, and enhancing patient engagement through effective communication. Committed to improving healthcare experiences by proactively addressing patient needs and facilitating seamless care transitions.

Work History

Customer Service Representative

CVScaremark
  • Engaged and educated members on Aetna plans and resources to enhance understanding.
  • Resolved inquiries and issues from members, providers, and plan sponsors.
  • Triage rework assignments to appropriate team members for efficient handling.
  • Documented interactions with members and stakeholders to maintain accurate records.
  • Guided members through benefits, policies, and regulatory compliance.
  • Built trust with members to anticipate and address their needs proactively.

Health Information Management Coordinator

Allegheny Health Network
  • Coordinated and oversaw clerical and clinical functions.
  • Performed clinical support duties, including preparing exam rooms and rooming patients.
  • Scheduled patients for procedures, diagnostic testing, and office visits.
  • Served as liaison between physicians and patients, providing necessary instructions.
  • Assisted healthcare providers with medical billing, coding, and reimbursement analysis.
  • Managed reimbursement policies submitted to insurance companies.
  • Supported front office operations, including registration and insurance verifications.
  • Ordered and tracked inventory of operational and clinical items.
  • Trained new employees on office protocols and procedures.
  • Coordinated health preventive care for patients and conducted weekly testing of office equipment.

Health Coach

Allegheny Health Network
  • Participated in population health outreach by identifying patients with care gaps using analytic tools and patient registries.
  • Facilitated pre-visit planning through chart and data reviews to prepare for patient visits and address necessary items.
  • Assisted providers in addressing care gaps and activating standing orders through an expanded rooming protocol.
  • Performed insurance verification and managed reimbursement processes, including rebilling claims and handling appeals.
  • Executed clinical transcription during patient encounters and assisted with computerized provider order entry.
  • Utilized motivational interviewing to coach patients in self-management, collaboratively set goals, and review after-visit summaries.
  • Conducted registry and quality data reviews to perform population outreach and close care gaps.
  • Collaborated with care team nurses to coordinate care for high-risk patients and facilitate complex care management referrals.
  • Reviewed and assessed population health management goals to enhance patient access and reduce emergency department visits.
  • Managed inventory of medical supplies and ensured sterilization and readiness of treatment areas.

Before and After School Care Assistant

The Learning Loft
  • Monitored students in before and after school programs.
  • Assisted children with homework and academic activities.
  • Facilitated food and gross motor activities for student engagement.
  • Communicated with parents regarding children's needs as instructed.
  • Maintained clean, organized, and safe program spaces.
  • Attended to children's academic and social needs during scheduled work hours.

Skills

  • Patient scheduling
  • Clinical support
  • Population health management
  • Care coordination
  • Patient education
  • Insurance verification
  • Regulatory compliance
  • Billing and coding
  • Inventory management
  • Team training

Timeline

Customer Service Representative

CVScaremark

Health Information Management Coordinator

Allegheny Health Network

Health Coach

Allegheny Health Network

Before and After School Care Assistant

The Learning Loft

Similar Profiles

CREATE PROFILE
Tamara Rainey