Tionne A. Ford
Louisville
Summary
Results-oriented Utilization Management Representative skilled in data analysis and compliance auditing. Experienced in assessing provider performance and developing training resources that enhance operational efficiency. Expertise in analyzing medical records, driving improved compliance and effective communication.
Overview
7
7
years of professional experience
Work History
Utilization Management Representative
HUMANA INC.
Louisville
09.2023 - Current
- Analyzed medical records to assess compliance with utilization management policies.
- Developed training resources for staff on utilization management processes to enhance compliance and knowledge.
- Analyzed data from member complaints, audit results, and outcomes to assess provider performance and drive quality improvements.
- Documented all authorizations accurately in patient medical records to ensure compliance with utilization management policies.
Accounts Receivable Coordinator
U OF L HEALTH
Louisville
03.2019 - 12.2022
- Maintained comprehensive records of collections activities, tracking contact attempts and payment arrangements to enhance follow-up effectiveness.
- Conducted periodic reviews of delinquent accounts and initiated appropriate action based on company policies.
- Analyzed customer account trends to identify actionable insights for improving the collection process.
- Prepared aging accounts reports for management review, facilitating informed decision-making.
Education
Associate of Science - Business Administration And Management
DECKER COLLEGE OF BUSINESS
Louisville, KY07-2004
Skills
- Utilization management
- Utilization review
- Care coordination
- Quality assurance
- Compliance assessment
- Data analysis
- Policy development
- Patient advocacy
Affiliations
Youth Leadership Academy (YLA), is a faith-filled experience for young people, designed to build character, friendship and growth.
Timeline
Utilization Management Representative
HUMANA INC.
09.2023 - Current
Accounts Receivable Coordinator
U OF L HEALTH
03.2019 - 12.2022
Associate of Science - Business Administration And Management
DECKER COLLEGE OF BUSINESS