Tiffany Davies

• Performed concurrent reviews for hospital admissions and assisted with discharge planning
• Reviewed and approved out patient and inpatient authorizations with MCG and Up to Date guidelines, collaborated with medical director
• Maintained current knowledge of out of net work process and knowledge of provider credentialing process
• Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.
• Performed telephonic evaluations with consistent basis to address changes in patient needs, conditions and medications, altering care plans when required.
• Team collaboration remotely, using video conferencing with Zoom and Microsoft Teams
• Managed caseload of 40 members, developed plans of care with member's goals and chronic conditions in mind

• Audited charts and reviewed clinical documents to verify accuracy, performed interviews with residents
• Assessed electronic medical record for required documentation to support MDS coding and submitted to Medicare and Medicare database in a timely manner
• Verified prompt and accurate completion of MDS activities for billing essential for facility to receive proper reimbursement
• Set schedules and trained staff in correct techniques for completing and signing MDS assessments.
• Conducted meetings with multidisciplinary treatment teams, caretakers, and families

• Served as resource to all hospital staff on all issues related to wound and skin care
• Implemented and wrote company standards of care, policies and procedures for wound care
• Substantial experience with wound care information and dressing teaching
• Responsible for ordering home wound care supplies for patients and clinic supplies
• Submitted insurance authorizations with timely and accurate documentation
• Coordinated home care and home infusions to reduce stress for patients

Class President

Class President