Tonya Williams

Graduated with a bachelors degree in Psychology, emphasis in applied psychology.

• Prepared a template of the final decision to the member regarding approval and denial of claims. (Average of 10 per day)
• Researched authorizations requested, medical records, and other documents for clinical review of claims. (Average of 10 per day).
• Corresponded with members, managers, clinical team, doctor offices, and other medical centers via phone and email. (Average of 5-10 calls and 50+ emails per day).

• Conducted treatment plan reviews to ensure all information was complete and accurate.
• Entered CPT codes and reviewed documentation to ensure that all payer supplemental forms, assessments, and appropriate signatures have been obtained.
• Aided Authorization Coordinators to ensure departmental timeliness and resolved low-level issues.
• Escalated concerns to ABA Therapist Supervisor and assisted in troubleshooting.
• Demonstrated proficient communication skills to keep all involved parties up to date on authorization status.
• Adhered to departmental timelines to facilitate efficient processing times.
• Gained knowledge of contracted and carved out insurance plans.
• Processed insurance authorizations for various insurance types.

• Scheduled client appointments for a 6-provider clinic.
• Checked in and checked out patients for appointments and collected co-payments.
• Answered high-volume multiline phone system, transferred calls to appropriate extension, checked voicemails daily, and took messages when necessary.
• Was responsible for all incoming nutrition and mental health referrals via CaseWare software.
• Handled high-volume insurance verifications for next-day and current appointments.
• Made appointment confirmation calls.
• Gained experience working with LGBTQ, HIV/AIDS positive, and Mental Health Clients.

• Recorded minutes for IRB committee meetings.
• Maintained departmental distribution lists and calendars.
• Assisted in creating, managing, and maintaining internal lists, charts, spreadsheets, and databases, and assisted in the collection of materials and data for special projects.
• Coordinated and assisted with special projects, tasks, duties, and provided other assistance as assigned.
• (Contract)

• Scheduled 6 meetings per month for Pathologists and managers in the Department of Lab Medicine and Pathology.
• Created agendas and meeting minutes for lab managers and department meetings, sat in to take minutes, and coordinated audio and video conferencing.
• Printed Pathology reports and looked up patient information in EMR system.
• Created and managed physician rotations and on-call schedules at the main hospital.
• Assisted in setting up training for the rollout of EPIC.
• Assisted with other projects as requested.

• Performed medical record audits to ensure quality management and compliance is being met.
• Obtained authorizations of release and mailed medical records out.
• Filed medical records by alphabetical order and MRN.
• Prepared medical charts and performed loose filing when necessary.

• Reviewed all invoices for appropriate documentation and approval prior to payment.
• Paid 50-100 invoices per day and processed 2-way and 3-way matches.
• Maintained the file room and performed loose filing when necessary.
• Researched problem PO numbers and checked to see if receivers were in the system.

• Worked primarily as the receptionist, signed in/signed out guests for interviews, sent email correspondence, and tracked all certified mail.
• Worked in the mail room as necessary, distributed mail for collections, banking, legal, etc., and scanned into the appropriate file for processing.
• Updated client’s collection notices to show updated balance and creditor.

• Scheduled interviews for prospective employees in various departments within the company.
• Front desk reception: answered calls and greeted coworkers and prospective interviewees.
• Administration tasks: reviewed prospect resumes, gave out parking validation, created expenditure in Excel, and performed various other administrative tasks as requested.