TIFFANY ALLEN
Chicago,IL
Summary
Highly motivated professional demonstrates ability to develop and implement successful plans of action to address individual needs. Possesses strong problem-solving skills to reduce barriers. Committed to helping individuals and families. Proven ability to work independently and collaboratively with diverse stakeholders.
Overview
11
11
years of professional experience
Work History
Outreach Referral Specialist
ReferWell
09.2021 - 12.2023
- Obtained precertification and other benefit information for the members of New York; who are Medicaid and Medicare recipients.
- Collaborated with medical providers and patient to obtain necessary documentation to evaluate patients' availability along with medical and physical condition to assess client needs for claim submission.
- Expedited claim approvals with timely submission of accurate and complete documentation, in some cases experienced resubmitting claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Reducing delays in payment processing, along with insurance carriers to discuss policies and individual patient benefits, and repayment objectives.
- Corresponded scheduled appointments with medical specialists on behalf of the client, or their PCP, while assuring timely verification of insurance benefits prior to patient procedures or appointments.
- Monitored and updated claims status in our claims processing system. While Generating a color coded system were posted and attached information pertaining to claim the files; Via Microsoft Excel.
- Implemented the ability to manipulate date, time, text, produce graphs and tables, use spreadsheets efficiently, build formulas, cell formatting, and perform calculations and task automation to process large volumes of data.
- Processed multiple referral requests from patients, doctors, and other healthcare professionals, along side maintaining accurate records on in-progress and completed referrals
- Ensuring full data integrity throughout the process
Senior Patient Service Representative
Advocate Medical Heart Institute
08.2018 - 09.2021
- Organized communication between patients, family members and medical staff via direct patient care, or on the companies switch board inbound call system
- Maintained data integrity, while verifying patient demographics and insurance information to ensure accuracy
- Keeping accurate and concise documentation of patient-related interactions
- Coordinated new intake documentation, HIPAA-mandated releases and other patient and office forms
- Oversaw front desk operations to maintain lobby, check in patients and coordinate general office reception
- Improved quality of care with diligent attention to patient needs and delivery strategies.
Law Clerk
Irman Law group
02.2013 - 07.2018
- Remotely delivered exceptional service to client calls by listening and documenting concerns to be reviewed by senior injury law executives
- Delivered a wide range of administrative support to clients regarding the state of the case with confidential protocol and integrity
- Managed deadlines consistently when preparing and filing court pleadings
- Created logical presentations of legal arguments in professional, error-free writing
- Investigated and validated reported issues, assessing risk and exposure
- Supported Injury hearings by coordinating witness statements and appearances.
Education
Bachelor of Arts (B.A.) - Communications -
Western Illinois
McComb, IL12.2012
Associate Of Arts General Studies - Early childhood development -
Olive Harvey College
Chicago, IL05.2010
High School Diploma -
Percy L Julian High School
Chicago, IL01.2009
Skills
- Insurance claims processing
- Negotiation and Resolution
- Conflict resolution
- Appeals Handling
- Exceptional customer support
- Organizational abilities
- Medical Advocacy
- Report Preparation
- Confidential Document Control
- Case Management
- Eligibility Determination
- Attention to Detail
- Patient Intake
- Filtering Data
Accomplishments
- As a Patient Service Representative; Referral specialist, and law clerk im glad to be delivering exceptional customer service and support to a number of individuals and assist in the overall well-being of clients and patients in need.
- I Received several Magias Awards, from accumulating a host of Patient satisfaction remarks
- Proficient in Microsoft Excel, and multi data software to develop inventory and tracking spreadsheets.
Timeline
Outreach Referral Specialist
ReferWell
09.2021 - 12.2023
Senior Patient Service Representative
Advocate Medical Heart Institute
08.2018 - 09.2021
Law Clerk
Irman Law group
02.2013 - 07.2018
Bachelor of Arts (B.A.) - Communications -
Western Illinois
Associate Of Arts General Studies - Early childhood development -
Olive Harvey College
High School Diploma -
Percy L Julian High School
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