Summary
Overview
Work History
Education
Skills
Timeline
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Tiffany Saunders

Pembroke Pines,FL

Summary

Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.

Overview

11
11
years of professional experience

Work History

Provider Service Representative/ Regulatory Specialist

Molina Healthcare
Miami, Fl
06.2020 - Current
  • Adhered to all applicable laws, regulations, standards, and procedures when interacting with providers.
  • Participated in training sessions as needed to stay current on industry trends and best practices related to Provider Services Representative duties.
  • Verified accuracy of submitted documentation prior to processing for credentialing.
  • Processed claims and coordinated with providers, payers, and other third parties as necessary.
  • Collaborated with team members to identify process improvement opportunities that could increase efficiency or reduce costs.
  • Analyzed reports generated from the system to ensure timely submission of claims and accurate reimbursement amounts.
  • Responded promptly to emails sent by providers concerning billing inquiries or other related matters.
  • Utilized job-related software to prepare change of address records and issue service discontinuance orders.
  • Investigated complaints about potential noncompliance issues raised by providers.
  • Drafted responses to inquiries from government agencies regarding ongoing investigations or enforcement proceedings.

Business Office Specialist

HCA Ambulatory Surgery Division
Aventura, FL
01.2019 - 03.2020
  • Conducted data entry of financial information into accounting software programs.
  • Provided customer service to internal and external clients regarding billing inquiries.
  • Processed payments from customers utilizing various payment methods including ACH transfers, credit cards, cashier's checks.
  • Maintained up-to-date knowledge of applicable laws and regulations related to business office activities.
  • Performed general administrative tasks such as scheduling appointments, ordering supplies, answering phones.

Human Resources Coordinator

Molina Healthcare
Miami, FL
01.2013 - 10.2017
  • Scheduled out of state interviews with our corporate directors in California via WebEx/ Television
  • Processed expense reports for department supplies as well as for traveling department employees
  • Maintained 99% survey result for new hire orientation participants
  • Scanned incoming mail into the database for customer and employee tracking.
  • Prepared correspondence such as letters, memos, emails, reports, presentations, and other documents with a high degree of accuracy.
  • Handled confidential information in accordance with company policies and legal requirements.
  • Provided administrative support to the Human Resources staff including filing documents electronically and physically.
  • Facilitated communication between departments within the organization related to HR issues.
  • Coordinated travel arrangements for HR staff members as needed.
  • Guided new hires through orientation and onboarding and explained documentation requirements to facilitate HR process.

Education

Associates of Science in Surgical Technologist -

Southeastern College
03.2020

Skills

  • Organization
  • Service Reporting
  • Calendar Management
  • Schedule Management
  • Complaint Handling

Timeline

Provider Service Representative/ Regulatory Specialist

Molina Healthcare
06.2020 - Current

Business Office Specialist

HCA Ambulatory Surgery Division
01.2019 - 03.2020

Human Resources Coordinator

Molina Healthcare
01.2013 - 10.2017

Associates of Science in Surgical Technologist -

Southeastern College

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Tiffany Saunders