Tiffany Hayes
786 Burbridge St,LA
Summary
Professional with history in remote customer service, skilled at delivering exceptional support and resolving client issues efficiently. Adept at utilizing communication skills and technical proficiency to enhance user experiences and meet organizational goals. Collaborative team player with focus on achieving results and adapting to changing needs.
Overview
8
8
years of professional experience
Work History
Medical Claims Processor
Humana
Remote
02.2025 - Current
- Processed medical claims efficiently, ensuring adherence to regulatory guidelines and company policies.
- Reviewed and validated claim submissions for accuracy, identifying discrepancies for prompt resolution.
- Collaborated with healthcare providers to clarify documentation requirements and expedite claim processing.
- Assisted in training new team members on claims processing standards and software utilization.
- Implemented process improvements that enhanced workflow efficiency and reduced claim turnaround times.
- Analyzed claims data to identify trends, contributing to strategic decision-making for operational enhancements.
- Maintained up-to-date knowledge of insurance regulations and best practices to ensure compliance in processing activities.
Healthcare Billing Specialist
Conifer Health Solutions LLC
Frisco, TX
11.2024 - 08.2025
- Processed healthcare claims using advanced billing software, ensuring compliance with industry regulations.
- Reviewed and corrected billing discrepancies, enhancing accuracy of patient accounts and reducing denials.
- Collaborated with healthcare providers to verify insurance eligibility and benefits coverage for patients.
- Implemented workflow improvements that streamlined billing processes, increasing efficiency in claims processing.
- Maintained up-to-date knowledge of coding guidelines and payer policies, ensuring consistent adherence to standards.
- Conducted audits of accounts receivable to identify trends and recommend strategies for improved collections.
- Trained new team members on billing procedures and software applications, fostering knowledge sharing within the team.
Customer Service Specialist
Whirlpool
Remote
09.2022 - 10.2024
- Resolved customer inquiries and complaints through effective communication and problem-solving techniques.
- Maintained accurate documentation of customer interactions in CRM system to enhance service quality.
- Assisted in training new team members on customer service protocols and company policies.
- Collaborated with cross-functional teams to streamline processes and improve customer satisfaction ratings.
- Improved customer satisfaction ratings by providing prompt, empathetic support to clients facing issues.
- Delivered exceptional service even during high-pressure situations, maintaining professionalism and composure at all times.
Front Desk Medical Receptionist
67 Pain and Injury
Duncanville, TX
08.2018 - 07.2019
- Managed patient scheduling and appointment confirmations, enhancing office efficiency.
- Maintained accurate patient records using electronic health record systems.
- Assisted patients with insurance inquiries, ensuring clear communication of benefits and coverage.
- Coordinated office workflow, optimizing front desk operations for improved patient experience.
- Facilitated effective communication between medical staff and patients to address concerns promptly.
- Oversaw inventory management of office supplies, ensuring availability of essential items for daily operations.
- Checked patient insurance, demographic, and health history to keep information current.
- Helped patients complete necessary medical forms and documentation.
- Ensured HIPAA compliance by maintaining strict confidentiality with all patient records and information.
- Handled financial transactions related to copayments or self-pay fees while adhering to company policies regarding payment collection.
- Kept waiting room neat and organized by stacking magazines, removing trash, and cleaning glass.
- Managed multi-line phone system and pleasantly greeted patients.
Education
High School Diploma -
Martin Highschool
Arlington Tx6 2018
Medical Assistant
Concorde Career College
Grand Prairie, TXSkills
- Critical Decision-making
- Customer service
- Claim denial resolution
- HIPAA compliance awareness
- Medical record review
- Organizational growth
- Claims processing proficiency
- Professionalism and ethics
- Medical Terminology Familiarity
- Insurance verification
- Continuous learning mindset
- Telephone etiquette
- Teamwork and collaboration
- Time management
Timeline
Medical Claims Processor
Humana
02.2025 - Current
Healthcare Billing Specialist
Conifer Health Solutions LLC
11.2024 - 08.2025
Customer Service Specialist
Whirlpool
09.2022 - 10.2024
Front Desk Medical Receptionist
67 Pain and Injury
08.2018 - 07.2019
High School Diploma -
Martin Highschool
Medical Assistant
Concorde Career College