Tiffany Moore
Columbus,OH
Summary
Personable and dedicated customer service representative with extensive experience in industry. Solid team player with upbeat, positive attitude and proven skill in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Articulate, enthusiastic and results-oriented with demonstrated passion for building relationships, cultivating partnerships and growing businesses. Multi-talented Project Coordinator successful at taking on diverse project tasks to meet tight deadlines. Hands-on and analytical problem solver. Provides excellent communication, planning and decision-making skills.
Overview
11
11
years of professional experience
Work History
Provider Credential Coordinator
Maximus Health Services
Columbus, OH
10.2021 - 07.2024
- Perform duties associated with the credentialing and recredentialing program for clinical staff. Including verification of all necessary provider licenses and credentials information.
- Maintain knowledge of current health plan requirements for credentialing providers, including managing delegated health plans.
- Managed multiple tasks simultaneously while meeting tight deadlines.
- Responsible for overall accuracy of and credentialing database, assuring that the information is current, and that the information is presented internally and externally in a timely and professional manner.
- Perform primary source verification of all practitioner credentials, including, but not limited to, licensure, DEA, and other sources.
- Complete provider credentialing and recredentialing applications in accordance with NCQA guidelines, monitor applications, and follow up as needed.
- Set up and maintain provider information in the online credentialing database and system.
- Working CAQH, PNM Microsoft office programs outlook, word, excel PECOS ADOBE system.
- Maintain necessary logs, lists, records, and current documentation required for provider credentialing.
- Ability to pay close attention to detail and produce extremely accurate work.
- Excellent communication skills both verbal and written, medical terminology and abbreviation knowledge.
Customer Service Representative
Linacre
Columbus, OH
11.2019 - 09.2021
- Work directly with medical professionals and physicians to facilitate patient care.
- Answered customer inquiries via phone, email, and chat.
- Advocate for and work lockstep with chronic patients. Provide outcome-based solutions for our physician referral sources and exiting patient population.
- Submit new orders and monitor their completion, from initiation to setup, working closely with the clinical, sales, and service departments.
- Prepare and analyze the billing and setup paperwork for patient service.
- Work closely with existing patients to troubleshoot, identify solutions, and dispatch corrective action via the appropriate departments.
- Recommend potential products or services to management by collecting patient information and analyzing customer needs.
Customer Service Representative
Automated Health Management Services
Columbus, OH
01.2017 - 07.2019
- Answered customer inquiries and provided accurate information regarding products and services.
- Assessed customer needs and provided tailored solutions for their individual healthcare requirements.
- Responded promptly to client inquiries via phone, email or other communication channels.
- Analyzed various health plans to determine which one best suits the customers' needs and budget.
- Performed data entry tasks such as entering customer information into databases accurately.
- Processed applications for health insurance policies and ensured accuracy of information provided.
Project Coordinator
Profit Line
Columbus, OH
01.2014 - 12.2016
- Monitored performance metrics such as cost, timeline, quality control and customer satisfaction levels.
- Analyzed data related to projects in order to identify areas for improvement or optimization opportunities.
- Assisted in troubleshooting network problems and monitored system performance.
- Developed and maintained user accounts, profiles, file systems, directories, access privileges and security settings.
- Resolved customer complaints via phone or email in a timely manner.
- Analyzed data from various sources, such as surveys, interviews, and focus groups. To inform decision-making related to projects.
- Collaborated closely with senior management on long-term strategic planning initiatives related to projects in development or execution stages.
Education
Nursing
Fortis College
Columbus, Oh10-2026
Health
Antwerp Local High School
Antwerp, OH05-2003
Skills
- Resource Allocation
- Recordkeeping
- Data Entry
- Document Management
- Information Collection
- Project Management
- Knowledge of medical terminology
- CAQH PRM Knowledge
- Microsoft Word
- Project management
- Computer IT skills
- Research
- Detail Oriented
- Ability to work under pressure and independently
Timeline
Provider Credential Coordinator
Maximus Health Services
10.2021 - 07.2024
Customer Service Representative
Linacre
11.2019 - 09.2021
Customer Service Representative
Automated Health Management Services
01.2017 - 07.2019
Project Coordinator
Profit Line
01.2014 - 12.2016
Nursing
Fortis College
Health
Antwerp Local High School
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