Summary
Overview
Work History
Education
Timeline
Generic

TIFFANY NICLO

Tonawanda,NY

Summary

Knowledgeable and organized Medical Billing Specialist with 8 years of experience in handling wide variety of billing tasks. Sophisticated and hardworking individual with excellent analytical and multitasking abilities. Coordinates with insurance companies and expedites claims processes.

Overview

14
14
years of professional experience

Work History

Medical Billing Specialist

Excelsior Orthopaedics, LLP
08.2020 - Current
  • Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
  • Organize weekly denial reports for assigned insurances and identify trends, write-offs as well as claim adjustments independently.
  • Oversee Highmark, Fidelis, UHC & Molina AR while distributing work to team members as needed
  • Maintain established relationships with insurance representatives to resolve claim issues.
  • Lead bi-weekly/monthly meetings with provider reps for Highmark & Molina.
  • Communicated effectively and extensively with other departments to resolve billing-related issues.
  • Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
  • Served as a subject matter expert on medical billing matters, providing guidance to colleagues on complex cases or unique situations.
  • Monitored changes in payer requirements and communicate with management as well as other departments accordingly to minimize disruptions in the revenue cycle.
  • Assist in training new hires on AR responsibilities
  • Analyze department reports, such as Total Joints
  • Manage patient accounts with Healthwell Foundation Grants and submit documentation needed to ensure payment
  • Oversee Team Self Pay and respond to inquiries in a timely fashion
  • Knowledge of credentialing process and serves as a back-up to assist with new provider onboarding.

Clinical Project Assistant

Sports Physical Therapy Of New York, PC
03.2020 - 08.2020
  • Complete and submit credentialing applications to 20+ insurance companies for individual therapists and facilities to obtain par status in order to treat patients
  • Established relationships with provider reps in order to quickly resolve any issues between insurance companies and facilities
  • Create and maintain all physical therapists CAQH profiles
  • Obtain NPI numbers for providers and facilities and updated existing profiles
  • Improved organizational filing systems for confidential employee records, resulting in improved accessibility and efficiency
  • Assist Clinical Director with special projects such as chart audits and Medent Support
  • Train Patient Service Coordinator's on new policies and procedures
  • In charge of keeping records for PMR inspections of equipment throughout all facilities, as well as AED machines and fire extinguishers
  • Verify insurance benefits prior to patient appointments in order for front desk staff to obtain accurate payments
  • Audit patient accounts and review ledger in Medent in order to send out personal statements to obtain missed payments
  • Assist in equipment / office supply inventory and ordering
  • Promoted from Patient Service Specialist and kept responsibilities and duties of PSS.

Patient Services Specialist

Sports Physical Therapy Of New York, PC
01.2016 - 02.2020
  • Proficient using Medent
  • Manage scheduling of patients for 10+ therapists/day and check in 70-100 patients/day
  • Manage payments and compile daily financial records
  • Prep and maintain charts for new and established patients
  • Inform and interface with patients regarding treatment plans and payment options
  • Help patients fill out necessary paperwork before appointments
  • Run Daily reports to assure patients had correct Rx and Authorization for upcoming appointments
  • Verify patient insurance coverage
  • Manage authorizations through patient's insurance companies to assure coverage for appointments
  • Run Personal Balance Reports for all facilities in WNY and distribute that information to facilitate collections
  • Run and distribute Inactivity reports for therapists and to facilitate follow-up calls to patients for scheduling
  • Obtain NPI numbers for providers and facilities and update existing profiles
  • Update CAQH profiles for physical therapists
  • Assist with training new hires on front desk procedures
  • Promoted from Patient Service Coordinator.

Bartender

Transit Lanes Keglers
10.2014 - 08.2020
  • Applied organizational and multitasking skills to handle simultaneous customer, team and business needs while avoiding unnecessary delays or errors
  • Polished glassware, bused tables and removed debris to keep customer areas fresh and clean
  • Organize special events and promotions such as trivia nights to bring in new customers
  • Maintained secure cash drawers, promptly resolving discrepancies with accuracy
  • Kept products well-stocked and organized to meet expected demands
  • Assisted servers with specialty drinks orders by preparing on-demand items without delay
  • Upsold menu items to customers, driving up per sale revenues and maximizing profits
  • Took customer orders and capitalized on opportunities to sell special beverage and food options
  • Kept accurate inventories and notified management of ordering needs for liquor, beer, wine and bar supplies
  • Organized bar inventory and storage procedures to keep stock within optimal levels and meet expected customer demands
  • Checked customers' identification to confirm legal drinking age
  • Assisted in preparing dining room for special upcoming functions
  • Set up bar for operation, obtained cash bank and stocked service bar.

Customer Service Lead

Tops Markets, LLC
06.2010 - 01.2016
  • Greeted all customers in warm manner and utilized active listening skills to determine assistance required
  • Evaluated customer information to explore issues, develop potential solutions and maintain high-quality service
  • Preserved revenue streams by utilizing strong communication and negotiation skills, offering refunds as last resort to maintain customer satisfaction
  • Stepped up to assist customer service manager with complaints and issues during times when department was short-staffed
  • Trained, oversaw and mentored new team members to strengthen performance and job expertise.

Education

High School Diploma -

Kenmore East Senior High School
06.2013

Timeline

Medical Billing Specialist

Excelsior Orthopaedics, LLP
08.2020 - Current

Clinical Project Assistant

Sports Physical Therapy Of New York, PC
03.2020 - 08.2020

Patient Services Specialist

Sports Physical Therapy Of New York, PC
01.2016 - 02.2020

Bartender

Transit Lanes Keglers
10.2014 - 08.2020

Customer Service Lead

Tops Markets, LLC
06.2010 - 01.2016

High School Diploma -

Kenmore East Senior High School

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TIFFANY NICLO