Teri Tame

Maintained and updated provider records across systems, resolved data discrepancies, and improved provider directory accuracy through reporting and cross-team coordination. Ensured provider data complied with regulations and supported claims and credentialing teams.

Managed electronic and paper medical records, ensuring accurate documentation, proper coding, and timely retrieval to support patient care and audits. Maintained HIPAA compliance and implemented security measures for record integrity.

Initiated and processed prior authorization requests, verified insurance eligibility, and tracked authorization statuses to facilitate timely approvals. Communicated with patients, providers, and payers and prepared appeals for denied authorizations.

Prepared and submitted complex prior authorization requests, managed follow-ups, and coordinated with providers and insurers to secure approvals. Maintained detailed authorization records and supported billing accuracy.

Handled member inquiries on enrollment, eligibility, benefits, and claims, resolving issues and escalating complex cases as needed. Documented interactions to maintain accurate member records and ensured regulatory compliance.

Pursuing a Bachelor of Science with a minor in Healthcare Management at Park University since January 2016.

Enrolled in a Human Resources Professional program and pursuing a Payroll Practice and Management certificate since August 2025.

Completed a Medical Office Specialist certificate program from January 2001 to February 2003.