Teiara Buford
Remote (Relocating To Charlotte, NC)
Summary
Operations and training support professional with 3+ years of experience facilitating onboarding, coaching staff on policies and workflows, and supporting knowledge transfer across distributed teams. Skilled in documentation standards, process education, and cross-functional collaboration within remote healthcare organizations.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Senior Utilization Review Specialist
Nextus Billing Solutions
12.2024 - 10.2025
- Coordinated end-to-end utilization review workflows across multiple behavioral health levels of care, ensuring timely decisions, regulatory compliance, and stakeholder alignment.
- Served as a primary liaison between clinicians, payers, and internal teams to resolve issues, prevent denials, and support continuity of services.
- Identified process and documentation gaps, providing guidance and informal training to clinical staff to improve consistency and outcomes.
- Managed high-volume, time-sensitive caseloads while prioritizing tasks and maintaining accuracy in a fully remote environment.
- Supported leadership and QA initiatives by improving intake processes and troubleshooting complex or problem cases.
- Collaborated asynchronously across teams and time zones using virtual systems, documentation tools, and structured communication.
Utilization Management Assistant Director
Prestige Management & Billing Solutions
11.2023 - 12.2024
- Led and coordinated daily workflows for a distributed team, ensuring alignment with policies, timelines, and operational priorities.
- Supported onboarding, coaching, and knowledge sharing for team members to strengthen performance and consistency.
- Acted as a point of contact between clinicians, physicians, QA, and payer partners to facilitate communication and resolve escalations.
- Analyzed operational data and trends to identify improvement opportunities and support decision-making.
- Coordinated appeals and peer reviews, tracking outcomes and ensuring follow-through across stakeholders.
- Contributed to process improvements that enhanced turnaround times and team efficiency.
Utilization Review Specialist
Oakwood Springs Hospital
11.2022 - 10.2023
- Coordinated authorization and review processes for inpatient and outpatient services, supporting timely access to care.
- Communicated with interdisciplinary teams to gather information, provide status updates, and ensure alignment on next steps.
- Tracked denials, appeals, and documentation requirements to support resolution and compliance.
- Maintained accurate records and followed structured workflows to meet regulatory and payer standards.
- Supported physician peer review coordination and follow-up to secure appropriate levels of care.
- Educated patients and families on post-discharge plans, resources, and expectations to improve engagement and follow-through.
- Collaborated with multidisciplinary teams to align care plans, timelines, and documentation.
- Maintained accurate records and ensured compliance with regulatory and organizational standards.
- Recognized for contributions to effective discharge coordination and patient support initiatives.
Registered Behavior Technician
JD McCarty Centers & Spectrum Schools
01.2015 - 01.2021
- Supported individualized behavioral programs by implementing structured plans under clinical supervision.
- Collected and documented data to track progress and inform adjustments to interventions.
- Collaborated with clinicians, educators, and families to ensure consistency and alignment across environments.
- Applied evidence-based strategies to support skill development and behavior change.
- Built strong rapport with clients and stakeholders through clear communication and consistency.
- Developed and implemented individualized behavior intervention plans for diverse student needs.
- Collaborated with multidisciplinary teams to assess and analyze students' progress and behaviors.
Education
Bachelor of Science - Behavioral Health Science With Trauma Emphasis
Grand Canyon University
Phoenix, AZ09-2025
Skills
- High-Volume Workload Management
- Workflow Coordination & Process Improvement
- Cross-Functional Team Collaboration
- Stakeholder & Client Communication
- Program Support & Tracking
- Documentation & Quality Standards
- Staff Coaching & Informal Training
- Onboarding & Knowledge Transfer
- Policy & Procedure Guidance
- Remote & Asynchronous Collaboration
- Office 365 (Excel, Word, Outlook)
- Time Management & Prioritization
Certification
- Certified Behavior Technician, BACB - 2022 - 2024
Timeline
Senior Utilization Review Specialist
Nextus Billing Solutions
12.2024 - 10.2025
Utilization Management Assistant Director
Prestige Management & Billing Solutions
11.2023 - 12.2024
Utilization Review Specialist
Oakwood Springs Hospital
11.2022 - 10.2023
Registered Behavior Technician
JD McCarty Centers & Spectrum Schools
01.2015 - 01.2021
Bachelor of Science - Behavioral Health Science With Trauma Emphasis
Grand Canyon University