Tiffany Daniels
Health Care
Missouri City,TX
Summary
Analytical, organized, and detail-oriented with drive and experience providing a superior level of customer service. Bringing forth the ability to properly investigate, evaluate, and negotiate situations and resolve claims quickly in accordance with company and regulatory guidelines. Demonstrating consistent execution of best claim practice and a commitment to industry and company ethics.
Overview
12
12
years of professional experience
1
1
Certification
1
1
year of post-secondary education
Work History
Administrative Medical Assistant
UT Physicians
07.2021 - Current
- Provided patient education to promote self-management skills, translating to the ability to effectively communicate with claimants and insured parties during the claims process.
- Assisted with medical record documentation, including intake/outtake notes, progress notes, physician orders, and reports, honing attention to detail and documentation skills crucial for claim adjusters.
- Identified and resolved complex problems impacting patients, transferring this skill to handling and resolving complex issues in insurance claims.
- Maintained electronic medical records for patients, demonstrating proficiency in maintaining organized and accurate records, which is vital in managing claim files.
- Ensured HIPAA compliance, reflecting an understanding of privacy and confidentiality regulations that can be applied to handling sensitive insurance information.
Administrative Medical Assistant
Houston Cardiovascular Associates
07.2018 - 01.2021
- Analyzed and extracted relevant patient information from medical records and effectively communicated findings to providers, showcasing the ability to extract pertinent details from claim-related documents and communicate with stakeholders.
- Identified and resolved complex problems impacting patients.
- Researched, analyzed, and reported on complaints, medical conditions, and potential interactions, skills that can be transferred to researching and analyzing insurance claims, potential fraud, and related issues.
- Communicated effectively with staff, insurance providers, and physicians about an myriad of issues, including urgent health concerns and inter-office communications, demonstrating strong communication skills that can be applied to collaborating with various stakeholders in insurance claims.
- Maintained medical files and managed electronic medical records to organize and keep records up-to-date to ensure compliance with regulatory requirements.
- Provided patient education and created an positive atmosphere for patients to receive care.
- Managed master calendar and scheduled appointments for providers based on optimal patient loads and clinician availability.
- Prioritized 70 customers calls per day through screening process and transferred calls and recorded messages for appropriate personnel.
- Trained and mentored incoming staff.
Medical Support Assistant- GS-0679
William Beaumont Army Medical Center
10.2017 - 09.2018
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Maintained detailed administrative and procedural processes to improve accuracy and efficiency.
- Examined claims forms and other records to determine insurance coverage.
- Determined nature and urgency of patient requests to refer patients to appropriate medical staff.
- Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
- Organized patient records to research records, extract medical information and review records for completeness and accuracy.
- Built positive rapport with patients to make patients feel comfortable during uncomfortable procedures.
Certified Family Child Care
Child Youth And Family Services
02.2016 - 05.2017
- Developed age-appropriate curricula and enrichment activities.
- Established and maintained routines for children's well-being.
- Managed multiple children with varying needs and maintaining schedules
- Communicated with parents about children's well-being.
- Addressed changes in a child's health or behavior and provide feedback to parents.
- Managed the safety and well-being of multiple children independently.
Administrative Medical Assistant
McLane Children’s Hospital Scott And White
02.2012 - 07.2014
- Proficient in data entry into Electronic Medical Records (EMR) systems.
- Facilitated communication between multiple stakeholders, including patients, clinical staff, physicians, and other healthcare providers.
- Ability to quickly assess information and respond to inquiries with open-ended questions.
- Demonstrated commitment to privacy and confidentiality, ensuring the protection of sensitive information in compliance with healthcare regulations.
- Skilled at researching and extracting pertinent details from documents.
- Efficiently coordinated and monitored various tasks, indicating strong time management skills
- Strong documentation skills, acquired through participation in meetings, observation of questioning processes, and note-taking.
- Proven ability to respond promptly to inquiries, ask relevant questions, and deliver information effectively.
- Experienced in assisting physicians with care-plan documents and medical record reviews.
Education
Associate of Applied Science - Social Work
Central Texas College
Killeen, TX12.2020
Bachelor of Science - Social Worker
Liberty University
Lynchburg, VA 01.2023 - Current
Skills
- Claim Handling/ Investigations
- Claim Reports/ Documentation
- Insurance policies and regulations
- Negotiation and conflict resolution
- Data Analysis/ Claim Settlement
- Problem Solving
- Strategic
- Teamwork/Collaboration
- Results-driven
- Focused
- Confidential Records Management
- Customer- focused Service
- Medical record documentation
- Problem-solving and complex case management
- Electronic medical records management
License
Independent Adjuster
All lines
Certification
CMAA - Certified Medical Administrative Assistant
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
There is a powerful driving force inside every human being that, once unleashed, can make any vision, dream, or desire a reality.
Tony Robbins
Timeline
Bachelor of Science - Social Worker
Liberty University
01.2023 - Current
Administrative Medical Assistant
UT Physicians
07.2021 - Current
Administrative Medical Assistant
Houston Cardiovascular Associates
07.2018 - 01.2021
Medical Support Assistant- GS-0679
William Beaumont Army Medical Center
10.2017 - 09.2018
Certified Family Child Care
Child Youth And Family Services
02.2016 - 05.2017
Administrative Medical Assistant
McLane Children’s Hospital Scott And White
02.2012 - 07.2014
CMAA - Certified Medical Administrative Assistant
Associate of Applied Science - Social Work
Central Texas College
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