Tonia Brinson

Completed patient assessments and obtained prior authorizations in a timely manor. Completed concurrent reviews for patient's, while ensuring all documentation meets the medical necessity guidelines. Maintained accurate records of authorizations, and completed follow up calls to the insurance, while working within multiple systems such as Medhost, Bestnotes and Sales Force. Communicated with the primary counselors and therapists about any insurance concerns or follow up questions. Informed clinical of any peer reviews or ares of concern. Maintained positive professional relationships with the insurance care managers. Completed SDI, FMLA and physician statements for the patients. Submitted appeals when necessary to avoid unauthorized services. Maintained open communication with all administrative, clinical and medical staff. Conducted trainings for staff to ensure patient care. Followed all HIPPA, code of conduct and ethics required by law. Completed chart to charge and audited patient's medical records to ensure documentation was complete and accurate

Utilization and Review Specialist-Completed patient assessments and obtained prior authorizations with insurance companies, such as Blue Cross, UBH, Aetna, UFCW and ILWU. Completed timely concurrent reviews and discharges. Maintained accurate records, and authorizations. Maintained professional relationships with the insurance care managers, completed follow up calls, and conducted peer reviews with the insurance companies doctors. Completed SDI for the patients and provided support when necessary. Maintained front office Supervisor duties, interviewing potential employee's. Answered incoming calls from potential admits, returned calls from families and potential patients, as well as phone calls for patient's that were already admitted, while always keeping patient's HIPPA. Facilitated groups that focused on relapse prevention, CBT, DBT, case management and aftercare planning. Conducted room searches and random urinalysis . Completed timely CIWA, COWS and blood pressure checks. Observed patient's while they administered and took their scheduled medications. Completed rounds and 15 minute checks. Provided resources for aftercare and discharge planning.

• Assisted colleagues in case management tasks when necessary, contributing to a supportive work environment that prioritized teamwork and collaboration among staff members.
• Collaborated with multidisciplinary teams to ensure comprehensive care for clients, addressing underlying mental health issues alongside addiction treatment.
• Kept up-to-date on current research in the field of addiction counseling through continuing education courses and professional development opportunities.
• Improved client recovery rates by developing and implementing individualized treatment plans tailored to their specific needs.