Tiffany Pugh
Madisonville,LA
Summary
A dedicated healthcare administrative professional with 15+ years of experience in patient access, member services, front desk operations, and senior living support. Skilled in patient registration, insurance verification, prior authorization, and high‑volume call handling. Known for delivering exceptional customer service, maintaining accuracy across multi‑system navigation, and supporting fast‑paced clinical and call‑center environments. Recognized for professionalism, empathy, and the ability to resolve issues quickly while ensuring compliance, efficiency, and a positive experience for patients, members, and families.
Overview
16
16
years of professional experience
Work History
Member Service Representative
Personify Health
Remote
10.2024 - Current
- Provided high-quality assistance to members by addressing benefit inquiries, resolving account issues, and guiding users through digital health tools.
- Managed high call volumes in a fast-paced environment while maintaining excellent customer service standards.
- Verified member eligibility coverage details and program participation across multiple platforms with precision.
- Investigate escalated concerns, coordinate with internal teams, and ensure timely resolution.
- Resolved member complaints effectively by actively listening, empathizing, and finding appropriate solutions.
- Maintain precise documentation of all interactions, updates, and case notes in CRM systems.
- Elevated member satisfaction scores by 100% through proactive communication and effective problem-solving strategies.
- Assist members in understanding claims status, denials, and required follow‑up steps.
- Educated customers on insurance products, explaining coverage options and helping them make informed decisions based on their needs.
- Participated in ongoing training sessions to stay updated on industry regulations, product enhancements, and best practices in customer service delivery.
- Guide members through enrollment processes for wellness programs, coaching, and digital health services.
- Support members with login issues, app navigation, and device connectivity.
Patient Access Representative
Ochsner
Slidell, LA
03.2022 - 10.2024
- Complete accurate patient check‑in and check‑out, verifying demographics, insurance, and consent forms.
- Confirm coverage, benefits, and authorization requirements for scheduled and walk‑in services.
- Obtain prior authorizations for imaging, procedures, and specialty visits to prevent delays in care.
- Schedule appointments, follow‑ups, and referrals while optimizing provider availability.
- Provide cost estimates, explain copays/deductibles, and collect payments at point of service.
- Enter and update patient information in Epic with accuracy and compliance.
- Assist patients with navigating hospital departments, understanding instructions, and resolving concerns.
- Uphold HIPAA standards and organizational policies in all interactions.
- Collaborated with healthcare team to ensure timely delivery of quality care to patients.
Lead Care Manager
Sunrise Senior Living
Metairie, LA
08.2010 - 05.2022
- Lead daily care operations, ensuring residents receive high‑quality, person‑centered support.
- Train, mentor, and supervise care staff to maintain safety and service standards.
- Follow individualized care plans, monitor changes, and report updates to nursing staff.
- Support medication reminders and documentation per facility guidelines.
- Ensure fall prevention, emergency response readiness, and safe mobility assistance.
- Facilitated communication by providing timely updates to families regarding care-related matters.
- Assist residents with bathing, dressing, meals, and activities.
- Work closely with nurses, therapists, and leadership to support resident well‑being.
Administrative Assistant
Sunrise Senior Living
Metairie, LA
04.2011 - 05.2022
- Facilitated communication by screening phone calls and emails for executives, ensuring accurate information delivery and appropriate inquiry redirection.
- Managed sensitive information with strict adherence to confidentiality protocols and data integrity standards.
- Facilitated administrative support for board meetings by preparing agendas, distributing materials, and following up on action items.
- Optimized office operations by implementing standardized processes and procedures.
- Designed and implemented efficient electronic and physical filing systems for streamlined document retrieval.
- Oversaw office supplies inventory management by proactively assessing needs and executing timely orders.
- Streamlined preparation and editing of correspondence, reports, presentations, and various documents.
Education
Certified Nursing Assistant
Nursing Assistant Network Association
New Orleans, LAAssociate of Science - Business Administration
Delgado Community College
New Orleans, LASkills
- Scheduling & Appointment Coordination
- High‑Volume Call Handling
- Patient Registration
- Customer Service Excellence
- Insurance Verification
- Multi‑System Navigation
- EMR/EHR Systems
- Claims & Billing Support
- Microsoft Office
- Data Entry Accuracy
- Prior Authorization
- Technical Troubleshooting
Timeline
Member Service Representative
Personify Health
10.2024 - Current
Patient Access Representative
Ochsner
03.2022 - 10.2024
Administrative Assistant
Sunrise Senior Living
04.2011 - 05.2022
Lead Care Manager
Sunrise Senior Living
08.2010 - 05.2022
Certified Nursing Assistant
Nursing Assistant Network Association
Associate of Science - Business Administration
Delgado Community College