Tiffany Allen
Boynton Beach,USA
Summary
Data-driven professional with A 20-year record of generating and building relationships, managing projects from concept to completion, designing educational strategies, and coaching individuals to success. Monitor, interpret, and analyze daily work production, performance metrics, and financial records with focus on proper controls and consistency. Take initiative and manage multiple, shifting priorities with strong attention to detail and follow-through. Excellent organizational skills with keen ability to work remotely/independently and meet deadlines.
Overview
22
22
years of professional experience
Work History
Business Process Analyst
Natera Inc
03.2023 - Current
- Develop, train, and deploy processes to resolve denials and/or underpayment for out-of-network providers under the No Surprise Billing Act, Independent Dispute Resolution Process.
- Power BI Dashboard to analyze, track, and trend payer performance, aging, collections, and denials for resolution.
- Manage vendor and audit performance to ensure processes and workflows are compliant with contractual obligations.
- Partner with stakeholders/clients to ensure addressing internal workflow issues, dispute process, billing requirements impacting aging, collection goals to resolution.
- Create SOPs to streamline processes to optimize work efforts with third-party vendors.
- Oversee meetings with Executive Leadership and Market Access Account Managers to deliver key metrics, workflows, trends, and performance and improvement opportunities.
- Quarterly meeting with executive leadership providing findings, resolutions, vendor, and payer.
- Continually review and monitor payor and state dispute regulatory changes, research, evaluations, and interpret guidance from a variety of sources to determine departmental actions.
- Present a PowerPoint presentation of the analysis on vendor and payer performance, aging and collections, and operational issues with resolution.
- Direct-driven results increased revenue by over $7M with payers, previously with little to no accounts receivable.
Data Analyst
Aspirus Inc.
Wausau, Wisconsin
11.2021 - 03.2023
- Analyze high-volume A/R to track and trend internal and external issues causing payment variances via Pivot tables & VLOOKUP’s.
- Interpreting hospital contractual agreements, managed care terminology, payer reimbursements, and contractual requirements regarding billing and collecting, assisting with appropriate language to support clean claims via revenue cycle with contract negotiators.
- Monthly cadence with payers, to resolve payment disputes, and recommend solutions to resolve claims issues, payor performance, establishing accountability and relationships with clients etc.
- Weekly cadence with senior leadership to inform of performance of insurance providers per contractual agreement, discovery of internal workflow systematic issues and/or contractual negligence etc. Determine best practices to reduce aging and increase collections efforts.
Vendor/Revenue Management Analyst
Tenet Healthcare
Boca Raton, FL
08.2003 - 03.2021
- Gathered operational and workflow requirements to document, implement, and monitor workflow processes. Identified root cause(s) of workflow/process incidents recommended solutions for consistency and positive outcomes.
- Worked independently and served as liaison between hospitals and outsourced A/R vendors; assisted with daily inquiries and any technical challenges they experienced with software applications.
- Analyzed reports related to revenue cycles and vendor management SLAs. Implement projects to reduce aging, increase collections.
- Identified critical process opportunities for enhancement and proposed tangible solutions to Operational Leadership, Client facilities, Process team, Contracting etc.
- Completed special projects and provided project support both independently and per request by senior leadership.
- Assist IT in creating Dashboards to display collections, assignments, aging etc.
- Trello to a collective platform to report current state of vendors and/or providers for all audiences.
- Managed performance and presented monthly presentations to leadership via PowerPoint.
- Monthly Meetings via conference call and/or face to face with Vendors & Operational Teams to present and discuss month to year performance/goals, budget, aging, opportunities for improvement, system enhancements/issues.
- Trained new team members within Vendor Management Team.
- Assisted leadership with the onboarding of vendors such as implementation contractual language, assisted IT with system integration, Process team with workflow, HR Profiles for system access and training on Conifer Systems.
- Confer with internal/outside counsel to refer global issues with exhausted efforts remaining unresolved due for payment.
- Invoice Reconciliation and overseeing for timely payment.
- JIRE tickets to communicate change of business needs, system issues, workflow modifications etc.
- SharePoint to upload reporting, documents etc.
- EPIC used for informational purposes as a Host system for clients.
Managed Care/Revenue Analyst
Tenet Healthcare
Boca Raton, FL
01.2009 - 07.2015
- Analyzed high-volume A/R to track and trend internal and external issues causing payment variances via Pivot tables & VLOOKUP’s.
- Interpreted hospital contractual agreements, managed care terminology, payer reimbursements, and contractual requirements regarding billing and collecting.
- Effectively communicated with payors, negotiated plans to resolve payment disputes, and recommended solutions to resolve claims issues.
- Showcase/Medi Finance to query data for analyst.
- Travel to Managed Care Plans to discuss business needs, training etc.
Managed Care Dispute Writer/Collector/Biller
Tenet Healthcare
Boca Raton, FL
12.2003 - 01.2009
- Interpreted contracts to determine the expected reimbursement manually to ensure proper balance and payment was received on the account.
- Disputed denied claims with Appeal Letter and all supporting correspondence.
- Identified and prepared various reports via Excel spreadsheet to upper management regarding payor denial trends, workflow issues, status of account greater than 180+ days old, etc.
- Identified appeals requiring Legal Action/Credit Adjustments.
- Processed claims rejected on clearing house editor and billed hard copy claims.
Education
Esthetician -
Palm Beach State College
Lake Worth, FLDiploma -
Olympic Heights High School
Boca Raton, FLSkills
- VLOOKUP
- XLOOKUP
- PIVOT TABLES
- Vendor Management
- Performance metrics
- Compliance monitoring
- Stakeholder engagement
- Analytical thinking
- Effective communication
- Team collaboration
- Attention to detail
- Presentation skills
- Problem solving
- Process change improvements
- Workflow Analysis
- Process improvement expertise
- Market analysis
- Team building
- Presentations and decks
- Revenue development
- Contract Interpretation
- Dispute Resolution
- CERNER
- EPIC
- Passport
- PowerBI
- Audits & Compliance
- MS Excel Spreadsheet/Formulas
- Graphs
- Workday
- Process improvement
- Data analysis
References
- Kristi Thomas, Payor Performance Analyst, Natera, Inc, 62-213-9062
- Elizabeth Villaverde, Senior Regional Account Manager, Natera, Inc
- Shaniece Crawford, Senior Director, NTT Data Services, 214-636-1462
Timeline
Business Process Analyst
Natera Inc
03.2023 - Current
Data Analyst
Aspirus Inc.
11.2021 - 03.2023
Managed Care/Revenue Analyst
Tenet Healthcare
01.2009 - 07.2015
Managed Care Dispute Writer/Collector/Biller
Tenet Healthcare
12.2003 - 01.2009
Vendor/Revenue Management Analyst
Tenet Healthcare
08.2003 - 03.2021
Esthetician -
Palm Beach State College
Diploma -
Olympic Heights High School