TONYA N ALEXANDER has been a healthcare professional with more than 19 years of Third Party Billing experience. Hardworking, motivated, dedicated, and a professional individual who is able to serve clients in a conscientious and pleasant manner. Proficient in Medical Insurance Billing, Medical Terminology and CPT-4 coding and ICD-9 coding. Disciplined, detail oriented with a strong ability to multitask and organize. Able to work well as a team member or independently. Able to complete assignments in a timely manner.
Microsoft Word and Excel, Athena, IDX, MediTech, NextGen
PRACTITIONER RATES ANALYST
Perform standard reimbursement /data analyses. Collaborate with Network
Development to analyze and report on the impact of practitioner negotiations.
Coordinate fee schedule approval process. Implement all approved fee schedules.
Perform industry and systems research to troubleshoot/resolve contractual rate issues.
Resolution of all billing inquires and collections. Payment posting, claim adjustments,
and follow-up of insurance remittance. Submitted weekly statements and set up Budget
plans. Set up of Electronic Remittance Advice of all insurance
Supervised billing department staff. Acted as liaison between nurse case manager and
adjusters to negotiate workers comp fees. Submitted claims appeals, distributed refunds
as needed, and made claims adjustments. Trained entire staff on billing systems (Clinical
Works and Athena net). Obtained physician insurance provider numbers
THIRD PARTY BILLING
Audited physician charts insuring correct level coding
MANAGED CARE SUPERVISOR
Supervised a staff of six Managed Care coordinators. Worked directly with the Practice
Manager to develop and implement policies and procedures. Scheduled OB/GYN
THIRD PARTY ANALYST
TEAM LEADER/ THIRD PARTY BILLING
Recognized for outstanding team leadership and was awarded a certificate of Appreciation entitled “The Team Leader on a Mission” in December 2002. Received a House of Representatives citation 8/86 for a 6 weeks internship. Worked in multiple healthcare services skincare, orthopedic, gyn and infertility. Completed medical terminology course at Mass General Hospital May/1999. Trained in HIPAA policies and procedures.
Bachelor of Science, Business Administration Concentration Health Care
Management, Minor: Healthcare administration, GPA: 3.76
Magna cum laude
Associate, Medical Billing and Coding, GPA: 3.76
Billing and coding highest honors
Associate, Computer Information Systems