Tamara Brown Email & Phone Number

Tampa, Florida, United States

Manages transaction cycle time (TCT) from Ready to Process to Funding Approval, making certain that all necessary steps are taken in the appropriate order ensuring timeliness of process and quality of funding approval.Ensure all client information (Minimum Documentation Requirement) is correct and is put into the work order.Verifies client benefits and coverage and communicates benefit information to client.Gathers and reviews documentation for funding package, including but not limited to: proper prescriptions, Letters of Medical Necessity (LMN), RTS evaluation information, price lists, forms (AOB, ABN, rent or purchase letter).Communicates regularly with Physicians, Therapists, RTSs, and Clients in an effort to secure documentation as required by payer.Investigates and updates any payer requirements.Maintains communication with client throughout the process when applicable, including notifying them of financial responsibility.Follows up with payer sources in order to obtain timely authorization, by properly working the Funding Work Queue.Requests and obtains proper approval for work order credit exceptions.Conducts pre-purchase quality assurance to ensure all approvals and requirements are met prior to purchase of equipment.Conducts pre-delivery verification to ensure all approvals and requirements are met prior to delivery of equipment.Posts deliveries daily upon verification of proper documentation.Works the Missing Information Request (MIR) and Front End Adjustment (FEA) reports weekly at minimum to address corrections and future errors.Performs any related job duties assigned by the Area Funding Director or Funding Supervisor. Carries out all position expectations in a professional manner and with minimal supervision.

Tampa, Florida, United States

Handles incoming Request for various medical services products based on date of receipt, date of service and customer to ensure appropriate actions are taken related to service level agreements. • Management of high level complex order escalations in a timely manner. • Working multiple limes of business queue with precis accuracy • Responsible for weekly reports and updating clients of order and billing status • Assisting with Implementation of new business procedures for better account accuracy and money management of order files.

Tampa, Florida

• Assist provider in questions regarding claims processing and authorization request.• Discuss treatment plans for current patients• Provide Billing and Claims processing explanations, on dental and medical outpatient claims.• Respond to telephone or written correspondence inquiries from members and/or providers within established timeframes utilizing current reference materials and available resources

Tampa/St. Petersburg, Florida Area

• Answers incoming calls from clients, therapists, payers, and ATPs.• Requests, collects, and reviews order documents to include Functional Mobility Evaluation (FME) and Letter of​Medical Necessity (LMN).• Request quotes from manufacturers for requested equipment.• Verifies Client Insurance benefits, reviews out of pocket, deductibles and any patient responsibilities.• Conducts research of related equipment on vendor websites.• Works directly with Home health, Outpatient rehab, and Hospitals to evaluate patients for custom equipment.• Handles order resolution when escalation is necessary• Awarded Top sales in New rehab for year 2016 for the Gulf South region• Trains all new hire CCC Onboarding, Numotion SOP, and Medicare Compliance.

Responsible for building a market for WellCare ‘s Iowa Medicaid expansion through credentialing different providers into Wellcare’s network.Handles a case load of about 15-20 contracts a day. I complete PLF entry of credentialing applications for Iowa providers into WellCare’s Systems. Scrub files for accurateness make sure all contracts are completed in their entirety and no missing or invalid information.Verifications of Providers NPI and Tax Id’s as well as up to date medical licenses and Liability insurance coverage. Once contracts have been through configuration and credentialing I am responsible for sending out completed contracts to provider along with WellCare’s claims guidelines and disclosures.

Tampa, Florida

Educate customers and providers about Humana’s products and services such as Medicare Advantage plans, Medicare supplement, and Group commercial coverage in Vision & dental policies to help guide in understanding plan documents Apply critical thinking skills to help solve errors in claims processing for medical claims.Pays close attention to details regarding established members accounts in order to answer any questions or grievance concerns the member may have regarding membership to Humana Inc.

Currently working on high visiblity contract for CMS called durable medical competitive bidding point of contact center for national diabetec supplies. Assist clients with billling inquires. Full knowledge of I-C9 codes. Applies knowledge of codes to help callers with appeal rights. Reviews claims for errors and assist clients with reprocessing of claims.

• Provided in store customer service support – resolving client’s issues, in a timely manner. Suggested new promotions that increased earnings by 23% within a quarter. Assistant Manager of the year for 2008.Top sales producer in store sales. Listen to Client needs and designed photo packages based on client needs.Handled all accounting and scheduling for store. Conducts interviews with candidates for employment for seasonal seasons.Performed all Administrative duties for store operations, filing of client records, Payroll reports, and employee records keeping for Brandon store location Provided training to all new associates in all aspects of the business. Increased sales from $74,000 to $120,000