Summary
Overview
Work History
Education
Skills
Timeline
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Tiffany Hall

Charlotte,NC

Summary

Experienced in quality improvement and regulatory compliance, with a track record of driving process enhancements and elevating client satisfaction. Skilled in data analysis and project management, ready to leverage expertise to support new initiatives. Seeking to contribute to a team focused on excellence in a dynamic environment.

Overview

11
11
years of professional experience

Work History

QUALITY ANALYST

Dane Street
05.2024 - 05.2025
  • Provided regular status updates to clients and ensured reports met all client and jurisdictional standards.
  • Evaluated physician reports for quality, clarity, and clinical rationale; ensured alignment with client expectations.
  • Coordinated and executed clarification and addendum requests, maintaining consistent communication with clients.
  • Participated in client calls and meetings to resolve questions related to reports.
  • Liaised with physicians to obtain accurate, timely documentation and secure final approvals.
  • Composed written/verbal feedback to physicians regarding report quality and requested clarifications.
  • Reviewed all reports for accuracy, including grammar, format, and adherence to state and client-specific requirements.
  • Ensured compliance with client handling instructions for report completion and delivery.
  • Oversaw report quality assurance processes, providing final approval prior to release.
  • Collaborated with the VP of Clinical Operations to report on quality issues and reviewer performance.
  • Drove process improvements to enhance turnaround times, reduce clarification requests, and boost client satisfaction.

SR. CASE COORDINATOR

Lincoln Financial Group
08.2022 - 09.2023
  • Processed increasingly complex data and financial transactions per established procedures and guidelines independently, promptly, and meeting departmental quality/production standards.
  • Ensured information is complete and in good order.
  • Created and maintained up-to-date procedural documentation as needed.
  • Communicated verbally and in written form effectively with applicable internal and external stakeholders to obtain increasingly complex required information while maintaining a professional demeanor in all interactions.
  • Communicated regularly with management on recognized trends of issues and/or concerns.
  • Resolved increasingly difficult customer contract discrepancies by investigating documentation and determining applicable adjustments.
  • Created new contracts as needed.
  • Provided customer service to internal and/or external stakeholders, recognizing what needs to be done to meet customer needs and demonstrating flexibility and responsiveness to meet customer needs.
  • Identified general issues/concerns and identified/recommended process improvements to positively influence the team and quality.

LTD CASE MANAGER

Lincoln Financial Group
08.2020 - 08.2022
  • Communicated with claimants and various medical professionals regarding LTD benefits.
  • Conducted initial and ongoing reviews to determine liability and benefit eligibility.
  • Made recommendations to approve or deny benefits accordingly.
  • Responded to various written and telephone inquiries regarding claim status.
  • Assessed financial impact of social security, workers compensation, and third parties.
  • Evaluated and referred claims to risk management resources such as Voc Rehab and Special Investigations.
  • Acted as a resource, mentor, and trainer to other Case Managers.

TECHNICAL ASSISTANT TEAM LEAD

Lincoln Financial Group
04.2016 - 08.2020
  • Company Overview: Liberty Mutual acquired by Lincoln Financial in 2018.
  • Effectively triaged disability claims and maintained assignment tracking.
  • Guided claimants on claim processing and documented inquiries.
  • Onboarded, trained, and oversaw 10 new insurance employees.
  • Handled escalated customer service issues and inquiries.

STD COMPLEX CASE MANAGER

Liberty Mutual
09.2014 - 04.2016
  • Reviewed, investigated, and managed complex short-term disability claims.
  • Applied legal and contractual provisions to risk-manage claims.
  • Used judgment and data systems to resolve claims within standards.

Education

Business Administration And Management

University of Phoenix
Tempe, AZ

Skills

  • Quality improvement
  • Quality processes
  • Data analysis
  • Project management expertise
  • Regulatory compliance
  • Case management
  • Learning and development
  • Critical thinking

Timeline

QUALITY ANALYST

Dane Street
05.2024 - 05.2025

SR. CASE COORDINATOR

Lincoln Financial Group
08.2022 - 09.2023

LTD CASE MANAGER

Lincoln Financial Group
08.2020 - 08.2022

TECHNICAL ASSISTANT TEAM LEAD

Lincoln Financial Group
04.2016 - 08.2020

STD COMPLEX CASE MANAGER

Liberty Mutual
09.2014 - 04.2016

Business Administration And Management

University of Phoenix

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Tiffany Hall