Typhanie Walker
Braddock
Summary
Experienced healthcare professional with 8 years of expertise in managing high caseloads in fast-paced environments. Skilled in updating diagnosis codes, submitting corrected claims, verifying and updating patient demographics, and reviewing claim exclusions to ensure accuracy and compliance. Organized, driven, and adaptable, with exceptional planning and problem-solving abilities. Committed to delivering high-quality results and eager to take on new challenges to contribute to organizational success.
Overview
10
10
years of professional experience
Work History
Claim Specialist
Natera Inc
07.2024 - 12.2024
- Reviews processed claims and inquiries to determine corrective action and takes the corrective action steps using enrollment, benefit, and historical claim processing information.
- Researches and analyzes claims issues.
- Updated diagnosis codes to ensure accuracy and alignment with current medical and insurance standards.
- Prepared and submitted corrected claims to address discrepancies and expedite payment processing.
- Verified and updated patient demographics to maintain accurate and complete records.
- Reviewed and managed claim exclusions to ensure compliance with policy terms and reduce errors.
ENGAGEMENT CENTER REP I
Advocate Aurora Health
04.2023 - 07.2024
- Evaluate medical eligibility by conducting insurance verifications to negotiate payment methods.
- Scheduling patient appointments and coordinating cancellations, rescheduled.
- Obtain demographic and insurance information, verify insurance coverage, and may collect co-pays, deductibles, and previous balances.
- Provide referrals to physicians/providers by following senior instructions ensuring information is accurate and correct.
- Identifies emergent calls based on information provided by caller and department guidelines.
- Submitting medication refill requests for evaluation, and paging providers and facilities as appropriate.
Medical Assistant Associate
Premier Medical Associate
05.2022 - 04.2023
- Collected and documented patient medical information such as blood pressure and weight
- Check schedules and organize patient flow
- Accompany patients to exam/procedure room
- Assist patients as needed with walking, transfers, dressing, collecting specimens, preparing for exam, etc
- Collect patient information/history, taking vitals, performing screenings per provider guidelines
- Relay instructions to patients/families
- Send/receive patient medical records in accordance with Health Insurance
- Portability and Accountability Act (HIPAA) and other state and federal regulations
- Prepare patient rooms, set up instruments and equipment according to department protocol
- Clean exam/procedure rooms, instruments, and equipment between patient visits to maintain infection control
- Clean according to scheduled maintenance program and keeping appropriate records
- Manage inventory of supplies; restocking exam/procedure rooms
- Perform phlebotomy, EKG's, and level one labs
- Perform clinic procedures according to policy and procedure
- Assist physicians with procedures
- Document patient information into the medical record.
Practice Assistant
Premier Medical Associate
10.2021 - 05.2022
- Responsible for registering new patients and updating existing patient demographics by collecting detailed patient information including personal and financial information
- Facilitates patient flow by notifying the provider of patient's arrival, being aware of delays, and communicating with patients and clinical staff
- Maintain and update patient records using data entry, faxing, and scanning
- Check next day charts for insurance eligibility and necessary referrals
- Prepare end of day reports, deposit slips, and upload to shared files daily.
Patient Care Technician
UPMC Shadyside
01.2020 - 04.2021
- Provides patient care including assisting with patient procedures and activities of daily living
- Assists with physical, respiratory, and cardiopulmonary therapies
- Performed core nursing assistant responsibilities (blood glucose, weights, vital signs, I&O, specimen collections and Foley care) AND at least four of the following BU identified tasks: phlebotomy, 12 lead EKG, simple dressing, Foley catheter removal, point of care testing, bladder scan, straight catheter, or IV catheter removal
- Assures equipment malfunctions are reported to the appropriate department
- Contributes to the universal unit activities including, but not limited to, responding to call lights and telephones, passing meal trays, and transporting patients.
Certified Nursing Assistant
UPMC Seneca Place
10.2017 - 01.2020
- Providing personal care to residents in providing bedpans, assisting with toileting and bathing and providing support in dressing and grooming
- Transferring the residents from one place to another while ensuring their comfort
- Weighing the residents on a periodic basis and make sure that all information is recorded in the computer immediately
- Providing emotional support to residents by listening to their problems and giving suggestions
- Competent at ensuring the personal hygiene and nutrition standards of residents
- Competent at handling bowel and bladder and recording results of the same
- Exceptional organizational abilities demonstrated through progressive caregiving positions.
Customer Service Advocate
United Healthcare
12.2015 - 08.2018
- Maintains accurate records, including timekeeping records
- Worked with Microsoft office, Facets, RX Claim, Icue, CareOne, Maces, tasktracker
- Sufficiently maneuvered through multiple systems on dual screens
- Assist member with scheduling wellness exams, PCP Check for prior authorizations
- Ask health-related questions, to ensure benefits
- Send out new materials including id cards, handbooks, provider directories, etc.
Customer Service Representative
CVS Caremark
10.2014 - 12.2015
- Properly directed inbound calls in phone queues to improve call flow
- Sufficiently maneuvered through multiple systems on dual screens
- Explained insurance plans and copays to members of all different ages.
Skills
- EMR / EHR
- Medical Terminology
- Insurance Verification
- Microsoft Office and G Suite
- Medical office administration
- ICD - 10 and CPT
- Referral and Prior Authorization
- Administrative and Clerical Procedures
Timeline
Claim Specialist
Natera Inc
07.2024 - 12.2024
ENGAGEMENT CENTER REP I
Advocate Aurora Health
04.2023 - 07.2024
Medical Assistant Associate
Premier Medical Associate
05.2022 - 04.2023
Practice Assistant
Premier Medical Associate
10.2021 - 05.2022
Patient Care Technician
UPMC Shadyside
01.2020 - 04.2021
Certified Nursing Assistant
UPMC Seneca Place
10.2017 - 01.2020
Customer Service Advocate
United Healthcare
12.2015 - 08.2018
Customer Service Representative
CVS Caremark
10.2014 - 12.2015
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