Summary
Overview
Work History
Education
Skills
Timeline
Generic

Tammy Collins

Winchester

Summary

Dynamic Senior Eligibility Specialist with extensive experience at Bluegrass Family Health, adept in data entry and effective communication. Successfully managed eligibility for over 250,000 insured, achieving a 90% service level. Proven track record in issue resolution and claims investigation, enhancing operational efficiency and team performance.

Overview

26
26
years of professional experience

Work History

Insurance Follow Up Associate

KMSF
06.2015 - 08.2023

Performed follow up functions for denied, aged and worked target files

Execute telephone or email contact with payers

Access multiple payer websites for claim status, eligibility and benefits

Maintain current knowledge of payer specific requirements for billing, coding, claim resubmission, claim appeals and claim resolution

Completes assigned special projects

Maintain strictest confidenitality; adhere to all HIPAA guidelines and regulations

Perform and complete assigned projects other related duties as assigned

Customer Service Supervisor

Bluegrass Family Health
12.1997 - 12.2014

Provided daily operational responsibilities for the Commonwealth Services Unit.

Provided complete service to the employees and retirees of the Commonwealth of Kentucky along with the providers who service those members.

Supervised, trained, monitored and evaluated a staff of 40 customer service representatives.

Assured member and provider inquiries/complaints were answered in a timely and professional manner.

Managed the Eligibility for over 250,000 + insured

Maintained 90% service level while meeting call requirements for 9 consecutive years.

Standardized eligibility process which improved the timeliness of reviews.



Senior Eligibility Specialist

Bluegrass Family Health
12.1998 - 10.2005
  • Promoted to Senior Eligibility Specialist December 1998. Administrator of database that housed membership for 115,000 + insured. Performed daily maintenance of the discrepancy file for the Commonwealth of Kentucky employee account. Researched the Diamond system for projects that involved Eligibility, claims, IT, HR and Finance departments. Supported the Director of Billing and Eligibility and functioned as team member for Open Enrollment and for HIPAA auditing.
  • I also functioned as Interm Supervisor for a 10 member staff.


Eligibility Coordinator

Bluegrass Family Health
12.1997 - 12.1998

Responsible for maintenance of member eligibility database, mailing of membership cards, welcome packets, Cobra and HIPAA notices. I interacted with other departments to resolve eligibility issues and billing discrepancies. Facilitated COBRA for state and commercial membership and cash posting. Processed refund requests for state agencies.

Education

George Rogers Clark High School
Winchester, KY
06-1985

Skills

  • Data entry
  • Effective communication skills
  • Microsoft office
  • Telephone etiquette
  • CAS
  • CCP
  • Diamond
  • Issue resolution
  • Claims investigation
  • Benefit Administration
  • Accounts Receivable and Payable
  • Eligibility
  • Call center operations

Timeline

Insurance Follow Up Associate

KMSF
06.2015 - 08.2023

Senior Eligibility Specialist

Bluegrass Family Health
12.1998 - 10.2005

Customer Service Supervisor

Bluegrass Family Health
12.1997 - 12.2014

Eligibility Coordinator

Bluegrass Family Health
12.1997 - 12.1998

George Rogers Clark High School
Tammy Collins