Overview
Work History
Education
Certification
Timeline
Generic

Tiffanie O'Connor Davis

New Orleans,LA

Overview

17
17
years of professional experience
1
1
Certification

Work History

Authorization Examiner

United Health Group
02.2016 - Current
  • Company Overview: People's Healthcare
  • Processed and managed pending claim authorizations, ensuring compliance with CCMS and organizational policies, and utilizing Amisys and Macess Flo systems to ensure timely resolution of Medicare Advantage claims.
  • Reviewed and resolved service forms assigned by management, consistently meeting production and accuracy targets, and addressed denied authorizations to maintain operational efficiency.
  • Generated MHNET reports and built inpatient psychiatric authorizations, thoroughly analyzing medical records to ensure the completeness and accuracy of requests.
  • Verified invoices and coordinated daily authorization operations, collaborating with management to resolve issues and improve workflows. Prioritize claims according to CCMS guidelines.
  • Coordinated with internal teams and stakeholders to resolve complex claims issues, ensuring timely and accurate resolutions in line with company objectives.
  • Utilized Sparq, Teams, Microsoft, Outlook, CCMS and eQ Suites
  • Managed high volume caseloads, prioritizing tasks to meet strict deadlines while maintaining attention to detail.

Claims Examiner

Lofton Temporary Agency
10.2015 - 02.2016
  • Investigated and reviewed claims in strict compliance with the Medicare Managed Care Manual, ensuring accurate processing in Amisys and comparing claims against Macess or EDI Viewer to identify discrepancies.
  • Resolved claim discrepancies by correcting errors and escalating unresolved issues to the Authorizations Department, ensuring seamless claims processing.
  • Recognized for consistent performance and offered a permanent position with People's Health due to contributions and expertise in claims processing.

VIP Hostess / Senior Server

Harrah's Casino
06.2013 - 10.2015
  • Delivered exceptional, customer-focused service to VIP clients, ensuring a personalized and welcoming experience. Utilized strong communication and problem-solving skills to resolve guest concerns efficiently, consistently enhancing customer satisfaction and loyalty.
  • Led daily operations as Room Lead, delegating tasks and coordinating activities to ensure seamless service delivery in dining and casino areas.
  • Managed cash handling responsibilities, including night depository drops, cash balancing, and change orders, maintaining accuracy and security.

Customer Service Associate

Liberty Bank and Trust
08.2008 - 02.2012
  • Supervised daily branch operations, including customer inquiries, check processing, and monthly financial reporting, ensuring efficient service and operational accuracy.
  • Managed cash flow and negotiable instruments for various financial transactions, including overseeing stakeholder accounts, processing levies and garnishments, and authorizing withdrawals exceeding teller limits.
  • Executed Night Depository operations, led weekly teller meetings, and spearheaded cross-selling initiatives to drive customer satisfaction and promote financial products.

Education

B.A. - General Studies

William Carey University
New Orleans, LA
05.2011

Louisiana Real Estate Commission
New Orleans, LA
08.2022

Certification

M & R Foundation Level 1

Timeline

Authorization Examiner

United Health Group
02.2016 - Current

Claims Examiner

Lofton Temporary Agency
10.2015 - 02.2016

VIP Hostess / Senior Server

Harrah's Casino
06.2013 - 10.2015

Customer Service Associate

Liberty Bank and Trust
08.2008 - 02.2012

Louisiana Real Estate Commission

B.A. - General Studies

William Carey University

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Tiffanie O'Connor Davis