Tiffany Simmons
Lakeland,FL
Summary
Highly experienced Accounts Receivable/Billing Specialist/Medical coder bringing 8+ years of experience carrying out all accounts receivable and billing functions in high volume environments. Stepped into management over 5+ years ago and have excelled growing companies and building strong teams. Proficient in claims submission, billing processes and team management. Recognized as dedicated professional driven to meet team targets and enhance bottom-line performance.
Overview
16
16
years of professional experience
Work History
Medical Billing Supervisor
Pediatric Gastroenterology at St Joseph's Hospital
Tampa, FL
12.2022 - Current
- Supervised day-to-day operations of the medical billing team including setting goals, delegating tasks and establishing deadlines
- Supervised daily operations in billing, delegated work to staff along with setting priorities and goals
- Submitted claims to insurance companies, researched an resolved denials and explanations of benefit rejections
- Monitored accounts receivable reports on a weekly basis to ensure timely payments from insurers.
- Maintained appropriate staffing level including hiring and terminating to ensure department goals are met
- Educated physicians & staff on correct coding requirements for procedures
- Developed strategies for improving collection rates while minimizing bad debt write-offs
- Managed invoicing and payment processing operations
- Corrected, completed and processed claims for multiple payer codes
- Posted payments from all insurance carriers
- Create hospital charges for ER/inpatient & outpatient
- Worked with team members and leadership to identify and develop process improvements
- Motivate all employees to be productive, stay positive and lend a helping hand when necessary to maintain unity and a healthy work environment
Accounts Receivable Specialist III (contract)
Lakeland Surgical & Diagnostic Center
02.2022 - 09.2022
- Ability to work in rotation work flow where job responsibilities change every two weeks
- Call patient to collect procedure fees
- Obtain authorizations for in office & outpatient procedures
- ICD-10
- Benefit verification
- Work company incoming bank statement, daily invoices and post all company payments
- Clean claim submission
- Reimbursement
- Medical Coding
- Work denied claims and send reconsideration for payment
Team Lead Benefits Specialist
Eye Specialist of Midflorida- 407 ave k SE
06.2020 - 09.2021
- Established accounts for new patients and updated existing accounts with current demographic and order information.
- Delegated work queues to employees
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
- Medical coding & ICD-10
- Obtained authorization for specific procedures and or injections
- Checked documentation for appropriate coding, catching errors and making revisions.
- Held regular one-on-one coaching sessions with staff members to encourage personal development.
- Supported the manager in developing plans for future projects, initiatives and objectives.
- Provided leadership and guidance to team members, ensuring that tasks were completed on time and to a high standard.
- Monitored team performance against targets, taking corrective action where necessary.
- Train new employees and generate score cards with employee progression report
- Generate superbill for doctors office in order to correctly bill patients for services provided
- Implemented procedure revisions & new policies
- Prevent impeding loss & increased profit
Medical Billing Specialist
Watson Clinic- 1600 Lakeland Hills Blvd
11.2017 - 11.2019
- Accessed patient information through various software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations.
- Epic system experience
- Scheduled and confirmed patient appointments with patients and healthcare professionals.
- Documented and managed patient information in computer system.
- Ran credit card batches and balanced deposits on daily basis.
- Claims submission
- Scheduled surgical procedures & assisted with pre-op information
- Scheduled patient appointments and procedures.
- Obtained proper authorization and identification to release confidential medical records.
- Scanned completed forms, identification and insurance cards, maintaining patient documents folder.
Collection Specialist
Rotech Healthcare- 6830 New Tampa Hwy ste 300
07.2014 - 11.2017
- Double-checked and reviewed documentation for denied and accepted insurance claims.
- Reviewed claims to ensure accuracy, resulting in multiple claim reductions.
- Investigated questionable claims to determine payment authorization.
- Researched and followed up on denied insurance claims.
- Consulted accountants, engineers, lawyers and physicians when needed.
Escalation Supervisor
GC Services- 1775 interstate Dr
04.2011 - 07.2014
- Utilized active listening skills to quickly resolve problems and escalated larger issues to cease further escalation.
- Trained employees on best practices and protocols while managing teams to maintain optimal productivity.
- Directed teams and assessed individual progress and efficiency with QA.
Dietary Aide/Medical Technician Supervisor
Emeritus Senior Living
04.2008 - 03.2011
- Initially hired as dietician and served specific meals to patients with special dietary needs.
- Helped with meal prep for daily meals, following strict sanitation and food handling guidelines
- Set tables before patients arrived to maintain meal plan productivity.
- Cleaned and maintained dining room during and after each meal service.
- Promoted to medical technician and observed and recorded vital signs and reported changes to physicians or nurses.
- Provided excellent patient support and care to patients and families.
- Documented and updated patient data on electronic medical charts, maintaining accuracy and confidentiality.
- Provide patients with scheduled medications and document in chart
Education
LPN - Licensed Practical Nurse
Traviss Technical College
06.2020
Certificate in Medical Billing & Coding -
DeVry University
01.2015
High School Diploma -
Mckeel Academy
05.2008
Skills
- Supervisor & leadership experience
- Billing & coding knowledge
- EMR system experience
- Epic, Paragon & Baycare System experience
- Athena Practice experience
- Accounts payable & receivable
- Project management
- Billing processes & Reimbursement
- Claims submission
- Microsoft Office expertise
- Development of office procedures
- Detail oriented
- Staff Training and Development
- Billing and Collection Procedures
- Chart Auditing
- Teamwork and Collaboration
- Customer Service
Accomplishments
- Proficient developmental training for new employees
- CEO recognition and company acknowledgment
- Extrinsic rewards
- Departmental promotions
- Received acknowledgment for bringing in over 1 million dollars of revenue within 1 year
Timeline
Medical Billing Supervisor
Pediatric Gastroenterology at St Joseph's Hospital
12.2022 - Current
Accounts Receivable Specialist III (contract)
Lakeland Surgical & Diagnostic Center
02.2022 - 09.2022
Team Lead Benefits Specialist
Eye Specialist of Midflorida- 407 ave k SE
06.2020 - 09.2021
Medical Billing Specialist
Watson Clinic- 1600 Lakeland Hills Blvd
11.2017 - 11.2019
Collection Specialist
Rotech Healthcare- 6830 New Tampa Hwy ste 300
07.2014 - 11.2017
Escalation Supervisor
GC Services- 1775 interstate Dr
04.2011 - 07.2014
Dietary Aide/Medical Technician Supervisor
Emeritus Senior Living
04.2008 - 03.2011
LPN - Licensed Practical Nurse
Traviss Technical College
Certificate in Medical Billing & Coding -
DeVry University
High School Diploma -
Mckeel Academy
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