Tiffany Allgood
Abilene,Texas
Summary
Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level Child and Family Services position. Ready to help team achieve company goals.
Overview
18
18
years of professional experience
Work History
Insurance Prior-authorization Specialist
Norman J. Dozier, MD, PA
10.2019 - Current
- Operate telephone switchboard to answer, screen, or forward calls, providing information, taking messages, or scheduling appointments.
- Greet persons entering establishment, determine nature and purpose of visit, and direct or escort them to specific destinations.
- Transmit information or documents to patients and/or other medical facilities using computer, mail, or facsimile machine.
- Hear and resolve complaints from patients or the public.
- Receive payment and record receipts for services.
- Schedule appointments and maintain and update appointment calendars.
- Train new employees.
- Verify insurance eligibility for surgical patients.
- Obtain insurance authorization for surgical procedures.
- Compute and quote estimated cost to patients for surgical procedures.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
- Improved patient satisfaction with timely and accurate processing of prior authorizations for surgical procedures.
- Provided training to new staff members on the intricacies of various insurance plans and their specific prior authorization requirements.
- Streamlined prior authorization processes by implementing efficient tracking systems.
- Fielded telephone inquiries on authorization details from plan members and medical staff.
- Reduced turnaround time for prior authorization requests by utilizing electronic submission methods.
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
- Assisted in the development of departmental guidelines and procedures for prior authorization processes, improving overall efficiency.
- Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
- Monitored pending cases closely, proactively following up on outstanding documentation needed for successful approval outcomes.
- Achieved high success rate in obtaining authorizations by effectively demonstrating medical necessity through comprehensive documentation and clear communication with insurance companies.
- Identified trends in denials through data analysis, adapting strategies accordingly for improved success rates in obtaining approvals.
- Supported team members by providing guidance on complex cases requiring detailed understanding of medical necessity criteria.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Developed and maintained productive working relationships with healthcare providers.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Maintained organized records and up-to-date files for all completed and pending authorization requests, ensuring easy access during audits or reviews.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Proved successful working within tight deadlines and a fast-paced environment.
- Applied effective time management techniques to meet tight deadlines.
- Worked effectively in fast-paced environments.
- Completed paperwork, recognizing discrepancies and promptly addressing for resolution.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Skilled at working independently and collaboratively in a team environment.
- Paid attention to detail while completing assignments.
- Passionate about learning and committed to continual improvement.
- Organized and detail-oriented with a strong work ethic.
- Developed and maintained courteous and effective working relationships.
Lead Scheduling Representative
Hendrick Provider Network
10.2015 - 10.2019
- Operate telephone switchboard to answer, screen, or forward calls, providing information, taking messages, or scheduling appointments.
- Greet persons entering establishment, determine nature and purpose of visit, and direct or escort them to specific destinations.
- Transmit information or documents to patients and/or other medical facilities, using computer, mail, or facsimile machine.
- Hear and resolve complaints from patients or the public.
- Perform administrative support tasks, such as proofreading, transcribing handwritten information, or operating calculators or computers to work with pay records, invoices, balance sheets, or other documents.
- Collect, sort, distribute, or prepare mail, messages, or courier deliveries.
- Receive payment and record receipts for services.
- Schedule appointments and maintain and update appointment calendars.
- Analyze data to determine answers to questions from customers or members of the public.
- Train new employees.
- Determine co-pays and patient financial responsibility.
- Obtain insurance authorization when required.
Phlebotomist
Brownwood Regional Medical Center
01.2010 - 10.2011
- Collect fluid or tissue samples, using appropriate collection procedures.
- Dispose of blood or other biohazard fluids or tissue, in accordance with applicable laws, standards, or policies.
- Dispose of contaminated sharps, in accordance with applicable laws, standards, and policies.
- Draw blood from capillaries by dermal puncture, such as heel or finger stick methods.
- Draw blood from veins by vacuum tube, syringe, or butterfly venipuncture methods.
- Explain fluid or tissue collection procedures to patients.
- Match laboratory requisition forms to specimen tubes.
- Organize or clean blood-drawing trays, ensuring that all instruments are sterile and all needles, syringes, or related items are of first-time use.
- Collect specimens at specific time intervals for tests, such as those assessing therapeutic drug levels.
- Conduct standards tests, such as blood alcohol, blood culture, oral glucose tolerance, glucose screening, blood smears, or peak and trough drug levels tests.
- Train other medical personnel in phlebotomy or laboratory techniques.
- Transport specimens or fluid samples from collection sites to laboratories.
Blood Bank Technician
Meek Blood Center
09.2008 - 03.2009
- Collect fluid or tissue samples, using appropriate collection procedures.
- Dispose of blood or other biohazard fluids or tissue, in accordance with applicable laws, standards, or policies.
- Dispose of contaminated sharps, in accordance with applicable laws, standards, and policies.
- Draw blood from veins by vacuum tube, syringe, or butterfly venipuncture methods.
- Explain fluid or tissue collection procedures to patients.
- Match laboratory requisition forms to specimen tubes.
- Organize or clean blood-drawing trays, ensuring that all instruments are sterile and all needles, syringes, or related items are of first-time use.
- Conduct hemoglobin tests to ensure donor iron levels are normal.
- Determine donor suitability, according to interview results, vital signs, and medical history.
- Enter patient, specimen, insurance, or billing information into computer.
- Monitor blood or plasma donors during and after procedures to ensure health, safety, and comfort.
- Process blood or other fluid samples for further analysis by other medical professionals.
- Serve refreshments to donors to ensure absorption of sugar into their systems.
- Train other medical personnel in phlebotomy or laboratory techniques.
Customer Service Representative
Sears Hometown Dealer
09.2006 - 01.2008
- Greet customers and ascertain what each customer wants or needs.
- Describe merchandise and explain use, operation, and care of merchandise to customers.
- Recommend, select, and help locate or obtain merchandise based on customer needs and desires.
- Compute sales prices, total purchases and receive and process cash or credit payment.
- Answer questions regarding the store and its merchandise.
- Maintain knowledge of current sales and promotions, policies regarding payment and exchanges, and security practices.
- Place special orders or call other stores to find desired items.
- Ticket, arrange and display merchandise to promote sales.
- Exchange merchandise for customers and accept returns.
- Clean shelves, counters, and tables.
- Sell or arrange for delivery, insurance, financing, or service contracts for merchandise.
- Open and close cash registers, performing tasks such as counting money, separating charge slips, coupons, and vouchers, balancing cash drawers, and making deposits.
- Resolve customer complaints regarding sales and service.
- Read catalogs, microfiche viewers, or computer displays in order to determine replacement part stock numbers and prices.
- Determine replacement parts required, according to inspections of old parts, customer requests, or customers' descriptions of malfunctions.
- Receive and fill telephone orders for parts.
- Advise customers on substitution or modification of parts when identical replacements are not available.
- Mark and store parts in stockrooms according to prearranged systems.
- Demonstrate equipment to customers and explain functioning of equipment.
- Place new merchandise on display.
- Discuss use and features of various parts, based on knowledge of machines or equipment.
Education
Bachelor of Science - Child And Family Services
Abilene Christian University
Abilene, TX12.2025
High School Diploma -
Career Preparatory Academy
Brownwood, Texas02.2002
Skills
- Telephone Etiquette
- Knowledgeable in Microsoft Office
- Workflow Management
- Data Entry
- Critical thinking abilities
- Patient Confidentiality Compliance
- Effective communication skills
- Records Maintenance
- Multitasking
- Organizational Skills
- Organization and Time Management
- Problem Resolution
- Cultural Awareness
- Friendly, Positive Attitude
Timeline
Insurance Prior-authorization Specialist
Norman J. Dozier, MD, PA
10.2019 - Current
Lead Scheduling Representative
Hendrick Provider Network
10.2015 - 10.2019
Phlebotomist
Brownwood Regional Medical Center
01.2010 - 10.2011
Blood Bank Technician
Meek Blood Center
09.2008 - 03.2009
Customer Service Representative
Sears Hometown Dealer
09.2006 - 01.2008
Bachelor of Science - Child And Family Services
Abilene Christian University
High School Diploma -
Career Preparatory Academy
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