TIFFANY HARRIS

• Collect, interpret, verify, and accurately enter data from referral sources and completed paperwork to process orders.
• Work closely with health plans/payers and maintain strong business relationships.
• Ensure the patient qualifies for the type and quantity of product(s) ordered based upon the patient’s insurance and/or contract guidelines. Obtain insurance authorization when necessary.
• Provide appropriate issue resolution and/or escalation when needed.

• Provides patient with appropriate Home health services to fit needs and location.

• Investigate and coordinate insurance benefits for insurance claims across multiple service lines
• Obtain claim status via the telephone, internet, and/or fax
• Review and understand eligibility of benefits
• Resolve accounts as quickly and accurately as possible, obtaining maximum reimbursement, and perform investigative and follow up activities in a fast-paced environment
• Conduct research, contact patients, and the local affiliates to include VA, Hospitals, and insurance carriers
• Handle incoming and outgoing mail, scanning, and indexing documents and handling any other tasks that are assigned
• Research and verify insurance billing adjustment identification to ensure proper account resolution and act when necessary
• Identify contractual and administrative adjustments
• Work independently or as a member of a team to accomplish goals
• Demonstrate excellent customer service, communication skills, creativity, patience, and flexibility
• Correspond with hospital contacts professionally using appropriate language while following the specific facility and department protocol
• Uphold confidentiality regarding protected health information and adhere to HIPPA regulation.

• Acts as a primary liaison with callers
• Educates customers on claim status, payment info, required time frames
• Enters verbal and written application info
• Assigns new claims to the appropriate handler
• Utilization Management Rep

• Collect, interpret, verify, and accurately enter data from referral sources and completed paperwork to process orders
• Work closely with health plans/payers and maintain strong business relationships
• Ensure the patient qualifies for the type and quantity of product(s) ordered based upon the patient’s insurance and/or contract guidelines
• Obtain insurance authorization when necessary
• Provide appropriate issue resolution and/or escalation when needed., Short term care coordination
• Assisting members and Health care providers with discharge planning needs
• Inpatient and outpatient services
• Dealing with ICD10 and Procedure codes to determine if auth is needed

• IT support on issues like connectivity and troubleshooting
• Solve more complex and technical customer problems
• Answering direct calls, transferred calls or trouble tickets, work with the latest systems and tools to
• Assist our customers.

• Greeted customers upon entry to the store
• Developed customer-oriented solutions to needs in the store
• Facilitated sales to assist with meeting store goals

• Handled inbound phone calls from customers troubleshooting and resolving advanced technical issues
• Assisted with account information, educating customers on purchasing information and provided specific content or account authorization
• Processed refund requests
• Provided promotion song and video code troubleshooting while supporting one of the largest technology companies in the world

• Provided customer with quality shopping experience
• Opened and closed store following all mandated store processes without error
• Maintained financial records and accurate cash counts during shifts
• Produced visually appealing and effective displays within store
• Consulted customers on latest styles and trends to increase sales and create brand loyalty
• Customer Service