Tiffany DeLillo
Crowley
Summary
Experienced Medical Insurance Specialist successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering 15 years of experience and willingness to take on any challenge.
Overview
19
19
years of professional experience
Work History
Switchboard Operator
Elevance Health
Grand Prairie, TX
07.2024 - Current
- Provided exceptional customer service by resolving issues promptly and accurately.
- Connected callers with appropriate professional, department, or business.
- Managed high volume of calls during peak hours, maintaining composure under pressure while efficiently handling each caller''s needs.
- Delivered excellent customer service through active listening skills and empathetic problem-solving approaches with callers'' concerns or complaints.
- Enhanced customer satisfaction by promptly addressing inquiries and directing them to the appropriate department.
- Strengthened company reputation by upholding confidentiality when dealing with sensitive information during call transfers.
Practice Manager
Kashif Anwar MD Pediatrics
Arlington, Tx
01.2023 - 07.2024
- Develop and maintain an employee handbook to standardize HR practices and ensure compliance with regulations.
- Manage accounts payable and oversee financial operations, including payroll processing and claim handling from creation to appeal resolution.
- Coordinate appointment scheduling and facilitate communication between staff and clients to optimize practice efficiency and client satisfaction.
- Supervised daily operations, ensuring compliance with healthcare regulations and internal policies.
- Coordinated patient scheduling and managed front office workflows to enhance efficiency.
- Supervised billing operations, ensuring timely invoicing and accurate account management.
- Implemented process improvements, enhancing efficiency in billing workflows and reducing errors.
- Managed escalated client issues related to billing, fostering strong relationships through effective communication.
- Enhanced billing accuracy by implementing efficient account management processes and strategies.
- Performed monthly reconciliations between billed amounts and collected revenues, ensuring alignment between accounting systems for accurate record-keeping purposes.
- Analyzed insurance claims to determine validity and compliance with policies
- Collaborated with clients and stakeholders to resolve disputes efficiently
Regional Director
Phytech Solutions
Garland, Tx
06.2020 - 12.2022
- Managed a team responsible for the accurate creation and timely processing of claims and appeals, ensuring compliance with updated billing rules and regulations in coordination with insurance companies.
- Directed the operational aspects of claims processing for multiple practices, contributing to an average annual profit of $2 million per practice.
- Improved payment entry procedures, enhancing the efficiency and reliability of the revenue cycle within the assigned region.
- Developed strategies to streamline claims processing, enhancing operational efficiency
- Trained staff on new software tools for enhanced claim tracking and reporting
- Examined claims forms and other records to determine insurance coverage.
- Verified insurance claims and determined fair amount for settlement.
- Maintained compliance with state regulatory requirements through meticulous documentation and adherence to company policies.
- Analyzed complex billing discrepancies to ensure timely resolution and payment processing.
- Developed comprehensive reports on claim trends, making strategic recommendations for operational enhancements.
- Facilitated communication between insurance carriers and policyholders to ensure clear understanding of coverage issues.
Practice Manager
Texas Wellness and Pain
Fort Worth, Tx
06.2017 - 10.2019
- Managed daily operations, ensuring smooth and efficient practice functionality.
- Directed the processing of medical billing claims and coordinated the appeals process.
- Collaborated with insurance company representatives to facilitate optimal patient care.
- Reviewed and corrected billing discrepancies to maintain accuracy in patient accounts.
- Processed medical claims efficiently to ensure timely reimbursement from insurance providers.
- Collaborated with healthcare providers to resolve billing inquiries and obtain necessary documentation.
- Implemented new procedures for claim submission, improving turnaround times for payments.
- Conducted audits of billing processes to identify areas for improvement and reduce errors.
- Developed training materials for staff on regulatory updates and best practices in medical billing.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
Practice Manager
Allcare Bone & Joint
Fort Worth, Tx
06.2009 - 06.2017
- Managed daily operations, ensuring efficient coordination of billing and appeals, and collaborated with insurance representatives to optimize patient care.
- Administered payment processing and bank deposits, accurately reconciling financial records to maintain the integrity of financial transactions.
- Enhanced practice profitability, growing annual revenue from $350,000 to $1.2 million over a three-year period.
Billing & Account Manager
Anchor Healthcare
McKinney, Tx
04.2007 - 06.2009
- Managed billing operations, including claim coordination and appeals processing, while collaborating with insurance representatives to optimize patient care outcomes.
- Handled financial transactions, including payment entries and bank deposit preparations, ensuring accuracy in coding claims and reconciliation of bank ledgers.
Education
Bachelor of Science - Healthcare Administration
The College of Health Care Professions
TX12-2025
Associate of Applied Science - Coding & Revenue Cycle Management
The College of Healthcare Professions
Fort Worth, Tx07-2022
Medical Coding & Billing - Health Information Tech - Medical Coding & Billing
The College of Health Care Professions
TX02-2016
Skills
- ICD-9 & ICD-10 Certified
- NRCCS Certified
- MS Office Expert Level
- Prior Authorization for Both Medical Care and Medications
- Referral Coordination
- Claim Appeals/Denials
- Account Reconciliation
- Account Payable/Receivable
- Patient Service Coordination
- Dependability
- Quick-learning
- Empathy and patience
- Flexibility
- Strong telephone etiquette
- Work prioritization
- Typing speed
Timeline
Switchboard Operator
Elevance Health
07.2024 - Current
Practice Manager
Kashif Anwar MD Pediatrics
01.2023 - 07.2024
Regional Director
Phytech Solutions
06.2020 - 12.2022
Practice Manager
Texas Wellness and Pain
06.2017 - 10.2019
Practice Manager
Allcare Bone & Joint
06.2009 - 06.2017
Billing & Account Manager
Anchor Healthcare
04.2007 - 06.2009
Bachelor of Science - Healthcare Administration
The College of Health Care Professions
Associate of Applied Science - Coding & Revenue Cycle Management
The College of Healthcare Professions
Medical Coding & Billing - Health Information Tech - Medical Coding & Billing
The College of Health Care Professions