Tiffaney Johnson
Sumter,SC
Summary
Detailed claims processor/customer service representative with several years of experience investigating claim information for correctness. Trustworthy teammate with benefit knowledge and rapport-building skills. Noted for thoroughness and ethical customer service.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Claims Processor/Customer Service Representative
Concentrix
Sumter, SC
06.2023 - Current
- Remote worker
- Identified trends in denials or rejections due to incorrect coding or billing practices by providers.
- Approving or denying the claim.
- Analyzed and evaluated claim forms, medical reports, bills, and other documents to ensure accuracy of data.
- Reviewed and verified insurance policy information to assess coverage and determine appropriate claims processing procedures.
- Applied knowledge of coding systems such as CPT-4 and HCPCS codes for proper reimbursement.
Personal Care Assistant (PCA)
Paradise Pointe
Sumter, SC
03.2018 - Current
- Assist clients with their daily self-helped skills
- Assist at doctors appointments
- Run errands
- Light Housekeeping
- Assist with giving medication.
Customer Service Representative
GC Services
Sumter, SC
09.2022 - 03.2023
- Assist customers with their bills
- Schedule appointments
- Helping customers process payments and take payments
- Answering multiple inbound calls
- Troubleshooting with customers over the phone.
House Manager
Broadstep Behavioral Health, Inc
Summerton, SC
04.2022 - 12.2022
- Provided primary resident care and assistance with daily living activities
- Provided caring companionship to elderly and developmentally disabled patients
- Chart daily information on residents such as mode changes, mobility activity, rating percentage, and daily input and output
- Comforted patient and provide them with reassurance and encouragement
- Perform household tasks
- Administered simple range of motions exercises
- Manage staff and assist with their needs such scheduling days off.
Customer Service Representative
Everise
Sumter, SC
11.2021 - 05.2022
- Set up client appointments
- Performed customer service surveys
- Assisted customers with a warm and professional attitude
- Answered calls from clients
- Answered general questions.
Personal Care Assistant
AT YOUR SERVICE
Sumter, SC
05.2017 - 03.2018
- Assist clients with their daily self-helped skills
- Assist at doctors appointments
- Run errands.
Direct Support Professional
Babcock Center, Inc.
Columbia, SC
03.2016 - 04.2016
- Provided primary resident care and assistance with daily living activities
- Provided caring companionship to elderly and developmentally disabled patients
- Chart daily information on residents such as mode changes, mobility activity, rating percentage, and daily input and output
- Comforted patient and provide them with reassurance and encouragement
- Perform household tasks
- Administered simple range of motions exercises.
PCA/CNA
Believe in Faith Home Health
Sumter, SC
07.2014 - 01.2016
- Provided primary resident care and assistance with daily living activities
- Provided caring companionship to elderly and developmentally disabled patients
- Light housekeeping and cooking.
Customer Service Representative
Sykes Enterprises, Incorporated
Sumter, SC
06.2013 - 09.2014
- Collected customer feedback and made process changes to exceed customer satisfaction goals
- Provided accurate and appropriate information in response to customer inquiries
- Addressed customer service inquiries in a timely and accurate fashion
- Trouble shooting with customers over the phone
- Answering multiple calls per day
- Helping customers order replacement cards.
Direct Support Staff
Sumter County DSN Board
Sumter County, SC
02.2008 - 08.2013
- Provided primary resident care and assistance with daily living activities
- Provided caring companionship to elderly and developmentally disabled patients
- Chart daily information on residents such as mode changes, mobility activity, rating percentage, and daily input and output
- Comforted patient and provide them with reassurance and encouragement
- Perform household tasks
- Administered simple range of motions exercises.
Caregiver
Lee County DSN Board
Bishopville, SC
07.2006 - 01.2007
- Provided primary resident care and assistance with daily living activities
- Provided caring companionship to elderly and developmentally disabled patients
- Chart daily information on residents such as mode changes, mobility activity, rating percentage, and daily input and output
- Comforted patient and provide them with reassurance and encouragement
- Perform household tasks
- Administered simple range of motions exercises.
Education
High school diploma -
Sumter High School
05.2003
Skills
- Personal Care
- Call Center
- Care Giver
- Customer Service
- Claims review
- Payments posting
- Medical terminology knowledge
- Small Claims Payouts
- Active Listening
- Team building
- Claims Processing
- Microsoft Office
- Developmental Disabilities Experience
- Meal Preparation
- Cleaning Experience
- Laundry
- Medication Administration
- Dementia Care
- Alzheimer's Care
- Autism Experience
Certification
- Driver's License
- AED Certification
- CPR Certification
- First Aid Certification
- BLS Certification
Additional Information
Understanding customers needs, Teamwork, Strong communication and interpretation skills., Eager to learn new skills., Understand mobility assistance needs., Trained in grooming and bathing., General housekeeping ability., Calm and level-headed under duress, Able to lift, Quick problem solver
Timeline
Claims Processor/Customer Service Representative
Concentrix
06.2023 - Current
Customer Service Representative
GC Services
09.2022 - 03.2023
House Manager
Broadstep Behavioral Health, Inc
04.2022 - 12.2022
Customer Service Representative
Everise
11.2021 - 05.2022
Personal Care Assistant (PCA)
Paradise Pointe
03.2018 - Current
Personal Care Assistant
AT YOUR SERVICE
05.2017 - 03.2018
Direct Support Professional
Babcock Center, Inc.
03.2016 - 04.2016
PCA/CNA
Believe in Faith Home Health
07.2014 - 01.2016
Customer Service Representative
Sykes Enterprises, Incorporated
06.2013 - 09.2014
Direct Support Staff
Sumter County DSN Board
02.2008 - 08.2013
Caregiver
Lee County DSN Board
07.2006 - 01.2007
High school diploma -
Sumter High School
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