Tiffany Ponce
Dallas,TX
Summary
Devoted professional proactively and quickly identifies best course of action for given scenarios. Confident handling tasks independently and in teams with highly organized approach to work. Strong advocate for those in need and committed to providing best possible service.
Overview
9
9
years of professional experience
Work History
Senior Service Advocate
Aetna, CVS Health
12.2021 - Current
- Coordinated with clinical professionals to evaluate concerns and resolve issues with pharmacy, dental, medical benefits
- Conducted in-depth research on complex problems to bring about satisfactory resolutions.
- Applied advanced computer and customer service skills to develop successful solutions to concerns.
- Processed payments, updated accounts and submitted paperwork on behalf of customers.
- Monitored progress towards service plan goals.
- Audited production reports, tracking data entry and processing errors.
- Resolved issues through active listening and open-ended questioning, escalating major problems to manager.
- Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
- Performed administrative duties by verifying documentation, researching facts and contacting other parties involved to determine fault percentages and minimize potential losses.
- Provided advice to customers regarding claims, rights and insurance processes to prevent disputes.
- Answered up to 50 telephone calls per day from company plan members
Account Manager
New Light Hospice
06.2019 - 07.2020
- Responsible for generating appropriate referrals from variety of sources by meeting with physicians, hospital discharge planners, and other hospital staff to promote hospice
- Highest referral generator from 15-20 admissions a month on the team
- Built and strengthened long-lasting client relationships based on accurate price quotes and customer-centric terms.
- Created proposals for new and repeat customer business transactions.
- New company, very eager to grow and start from ground up
- Created new forms to help with consents and forms, making process easier for families
- Maintains community visibility; attends networking programs
- Facilitates and coordinates education programs and opportunities in hospitals, physicians offices and community settings
- Track and report monthly contacts with referral sources and submit to supervisor
- Host and direct marketing events, health fairs, public relations as needed
- Assist with admission process by meeting with patient and/or responsible party and complete documentation as needed or assigned.
- Worked diligently to resolve unique and recurring complaints, promoting loyalty, and enhancing operations.
Territory Manager
Vantage Hospice
04.2018 - 05.2019
- Providing hospice information to families through Medicare Hospice explanation of benefits
- Analyzed sales data to identify areas for territory improvement and implemented strategies to maximize sales growth.
- Assisting in completing consent paperwork with patients and families
- Completing referral process tasks through working with families and hospital case managers along with communicating with doctors, and keeping everyone updated
- Maintain relationships with existing referral sources in effort to grow company census
- Generating established accounts through sales and marketing efforts
- Participate in Networking opportunities to promote company name recognition
- Assist with and attend Marketing Events outside of normal business hours
- Maintain compliance with company related reports, including but not limited to Payroll, Expense Reports, Marketing Reports and assignments
- Achieved sales goals and service targets by cultivating and securing new customer relationships.
- Managed over 25 accounts within Sugar Land and Fort Bend territory
Office Assistant II
Memorial Hermann Rehabilitation
03.2015 - 04.2018
- Completed clerical tasks such as filing, copying, and distributing mail.
- Interacted with customers by phone, email, or in-person to provide information.
- Maintained and updated office records, both digital and physical.
- Welcomed office visitors and alerted staff to arrivals of scheduled appointments.
- Receptionist for Chief Nursing Officer, which included jobs of filing, answering phones, setting up Joint Commission Meeting, Nurse Council, Town Hall, and more.
- Coordinated Employee Campaign 2 years in a row, raising money for patient care.
- Worked 12 hour shift as Unit Secretary on the floor for 35 beds. Developed patient charts, door hanger, assigned nurses and patient care assistants a schedule. Called doctors for patient consults, patient emergencies, or for orders needed.
- Assisted Outpatient and Inpatient Therapy Department by answering calls, patient questions and physician request. Also scheduled patients, registered new patients into the system, accepted payment if needed, and create 35 therapist schedules a day.
- Designed schedules for up to 35 patients in the Inpatient Therapy Department, along with assisting Occupational therapist in developing groups for patients.
Education
Bachelor of Science - Biology
University of Houston – Downtown
Houston, TX2024
Associate Degree - Science
Lone Star Community College
Cypress, Texas2017
High School Diploma -
Cypress Falls High School
Houston, Texas2011
Skills
- Power Point Outlook Healthquest
- Microsoft Word ReportSafe Fax, copy and scan
- Excel, MyActiveStaffer,CARE4, EpicCare
- PeopleSafe, GPS, ASD, CISCO Jabber, ECHS, WFO, IOP Document
- Consultative Sales Approach
- Coordinate Service Referrals
- Medical Records Review
- Prepare Reports
- Call Volume Analysis
- Client Relationships
- Program Coordination and Execution
- Member Relations
- Conduct Home Visits
- Team Goals
- Clinical Knowledge
- Educational Programs
Languages
Spanish
Native or Bilingual
Timeline
Senior Service Advocate
Aetna, CVS Health
12.2021 - Current
Account Manager
New Light Hospice
06.2019 - 07.2020
Territory Manager
Vantage Hospice
04.2018 - 05.2019
Office Assistant II
Memorial Hermann Rehabilitation
03.2015 - 04.2018
Bachelor of Science - Biology
University of Houston – Downtown
Associate Degree - Science
Lone Star Community College
High School Diploma -
Cypress Falls High School
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