Tracy Edwards
6257 University Ave N Apt 304
Summary
Dynamic professional with a proven track record at UCare of Minnesota, excelling in resolving complex provider claims and enhancing operational efficiency. Known for strong problem-solving abilities and a friendly demeanor, I build lasting relationships while ensuring accurate claims processing and effective communication. Adept at multitasking and maintaining attention to detail in fast-paced environments.
Overview
10
10
years of professional experience
Work History
Provider Assistance Center
UCare of Minnesota
10.2022 - Current
- Resolved complex provider claims discrepancies through detailed analysis and effective communication with stakeholders.
- Collaborated with cross-functional teams to streamline claim resolution processes, enhancing operational efficiency.
- Act as the main point of contact for healthcare providers, building and maintaining positive, long-term relationships. Review, research, and process medical claims submitted by healthcare providers, and ensure they are processed in a timely and accurate manner.
- Ensure adequate supporting documentation is provided and vet claims against program rules.
- Investigate and resolve claim discrepancies, edits, and rejections, potentially by contacting providers or other third parties.
- Providing knowledgeable information and resources regarding medical program eligibility, benefits, managed care policy and payment process.
- Assist with pharmacy and medical grievance and appeals.
Patient Financial Services Representative II
Park Nicollet Methodist Hospital
09.2019 - 10.2022
- Processed patient billing inquiries, ensuring accurate account information and timely resolution of issues.
- Collaborated with insurance providers to verify coverage and facilitate claims processing.
- Educated patients on financial responsibilities, payment options, and available assistance programs.
- Managed collections for outstanding balances, enhancing patient communication strategies to improve recovery rates.
- Notified patient and/or guarantor of self-pay balances co-pays/deductible and coinsurance.
- Meet department goals and maintain productivity while working remotely.
- Bad debt management of accounts and interactions with vendors.
Appointment Scheduler
Allina Health
04.2016 - 09.2019
- Scheduled patient appointments using electronic health record systems to optimize clinic workflow.
- Coordinated communication between patients and healthcare providers to enhance service delivery.
- Managed appointment reminders to minimize no-show rates and improve patient attendance.
- Facilitated intake processes by collecting necessary patient information efficiently and accurately.
- Handle client inquiries and resolve scheduling conflicts.
- Verify client information and update records as needed.
- Utilize and maintain scheduling software and other office tools.
Education
No Degree - Nursing
North Hennepin Community College
Minneapolis, MN06-2029
Skills
- Friendly, positive attitude
- Teamwork and collaboration
- Customer service
- Problem-solving
- Time management
- Attention to detail
- Flexible and adaptable
- Dependable and responsible
- Multitasking
- Critical thinking
- Computer skills
- Organizational skills
- Active listening
- Calm under pressure
Timeline
Provider Assistance Center
UCare of Minnesota
10.2022 - Current
Patient Financial Services Representative II
Park Nicollet Methodist Hospital
09.2019 - 10.2022
Appointment Scheduler
Allina Health
04.2016 - 09.2019
No Degree - Nursing
North Hennepin Community College