Tiffany Moore
Columbus ,Ohio
Summary
Dynamic Care Coordinator with a proven track record at Quantum Health, excelling in patient advocacy and case management. Skilled in documentation and claims processing, I enhanced customer satisfaction through empathetic communication and efficient problem-solving. Successfully streamlined administrative processes, achieving high levels of client trust and timely interventions for optimal health outcomes.
Overview
8
8
years of professional experience
Work History
Care Coordinator
Quantum Health
01.2024 - 06.2025
- Used company software and databases to maintain records of services performed and patient conditions.
- Managed patient caseloads effectively, ensuring timely follow-up and appropriate interventions.
- Developed strong relationships with community partners, facilitating referrals and collaboration on behalf of patients.
- Conducted regular evaluations of care plan effectiveness, making necessary adjustments based on feedback from patients and providers.
- Maintained accurate and up-to-date documentation of patient records in accordance with HIPAA regulations.
- Assessed patient needs and connected them with appropriate resources to ensure optimal health outcomes.
- Advocated for patients'' rights within the healthcare system, working diligently to address concerns or barriers to care.
- Enhanced customer satisfaction by providing accurate and timely information on health insurance policies and benefits.
- Achieved consistent high levels of customer satisfaction through empathetic listening and problem-solving skills when addressing concerns or disputes.
- Increased overall efficiency by streamlining administrative processes related to filing claims paperwork and managing databases containing vital client information.
- Assisted clients in understanding complex insurance terms and conditions, leading to better decision-making and policy selection.
- Enhanced customer satisfaction by efficiently managing insurance claims processes and providing timely resolutions.
- Followed up with customers on unresolved issues.
Customer Financial Services Representative
Reliant Capital Solutions
03.2017 - 03.2019
- Utilized advanced skip-tracing techniques to locate hard-to-find debtors, increasing the likelihood of successful collections efforts.
- Proficiently managed a high-volume workload of inbound calls from customers seeking assistance with their past-due balances.
- Negotiated settlements within approved guidelines while preserving positive customer relationships whenever possible.
- Contacted customers to discuss past-due accounts and negotiated payment plans.
- Responded to customer inquiries and provided detailed account information.
- Maintained accurate records of customer accounts, payments and payment plans.
- Worked with customer to create debt repayment plan based on current financial condition.
- Established relationships with customers to encourage payment of delinquent accounts.
- Listened to customers and negotiated solutions that met creditor and debtor needs.
- Processed debtor payments and updated accounts to reflect new balance.
Credentialing Coordinator
Maximus
08.2022 - 10.2024
- Built strong relationships with clients to deliver emotional support and companionship.
- Educated patients on self-care strategies, promoting independence and empowering them to manage their health conditions.
- Monitored progress towards patient goals, adjusting care plans as needed to achieve desired results.
- Enhanced patient care by developing and implementing comprehensive care plans.
- Maintained accurate files, records and credentialing documents in well-maintained databases using Software.
- Contributed to risk management initiatives by monitoring expiring licenses, certifications, and insurances, notifying providers of renewal requirements in a timely manner.
- Improved turnaround times for processing credentials by diligently reviewing and verifying provider eligibility.
- Reduced errors in documentation by thoroughly auditing provider files for completeness and accuracy.
- Worked closely with practitioners to help each obtain privileges at assigned healthcare facilities
- Strengthened relationships with external agencies by responding promptly to verification requests and inquiries regarding providers'' credentials.
- Tracked expiration dates on documents and communicated with appropriate staff to avoid late filing.
- Received and evaluated applications to look for missing and inaccurate information.
- Conducted primary source verifications such as background checks and board certifications.
- Obtained NPI numbers for providers and facilities and updated existing profiles.
Customer Service Representative
Huntington National Bank
01.2019 - 09.2021
- Assisted in fraud prevention efforts by closely monitoring customer accounts and reporting suspicious activity as required.
- Assisted customers in navigating online banking platforms, improving their overall digital banking experience.
- Resolved complex customer situations by utilizing problem-solving skills and escalating issues when necessary.
- Maintained strict adherence to compliance regulations, ensuring all transactions were accurately processed and documented.
- Developed strong relationships with clients through personalized service, building trust and loyalty with the bank.
- Improved customer experience by providing timely and accurate responses to inquiries about banking products and services.
- Coordinated with other departments to address and solve complex customer issues.
- Maintained up-to-date knowledge of banking regulations, ensuring compliance and customer protection.
- Resolved customer complaints, restoring confidence in bank services and retaining valuable clients.
- Managed high volume of inbound calls, ensuring prompt and professional customer service.
- Managed complex cases involving identity theft, credit card fraud, and other forms of financial crime, resulting in successful resolution for affected customers.
Education
Associate Degree In Nursing - Nursing
Aiams
Columbus Ohio She Diploma -
Antwerp High
Antwerp, OH05.2003
Skills
- Case management
- Documentation
- Patient education
- Organizational skills
- Patient advocacy
- Medical terminology understanding
- Documentation proficiency
- Claims processing
- Quality assurance
- Organizational standards
- Problem-solving
- Time management
- Multitasking and organization
- Active listening
Timeline
Care Coordinator
Quantum Health
01.2024 - 06.2025
Credentialing Coordinator
Maximus
08.2022 - 10.2024
Customer Service Representative
Huntington National Bank
01.2019 - 09.2021
Customer Financial Services Representative
Reliant Capital Solutions
03.2017 - 03.2019
Associate Degree In Nursing - Nursing
Aiams
She Diploma -
Antwerp High
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