TIFFANY SMITH

• Maintain accurate reimbursement by loading, updating and maintaining contracts for all commercial and government payers including but, not limited to program changes as a result of network pricing, pricing schedules and Letter of Agreements.
• Generates various reports and collaborates with Billing Group and Division AR Staff daily to identify, investigate and resolve discrepancies or errors preventing revenue from booking accurately.
• Loads, maintains and updates accurate fee schedules and reimbursement rates on a monthly or quarterly basis or as needed to accommodate individual programs.

• Manage daily facets for over 15 Patient Account Representatives.
• Achieved 50% reduction in aging from 12-week average to a 4-week average.
• Monthly reconciliation of void and rebills reporting as a result of changes of insurance.
• Implementation of policies and procedures and quality assurance through random auditing.
• Ensure accuracy & timely completion of team duties.
• Develop internal processes to build efficiencies.
• Proficient in identification of trends related to insurance nuances.

• Worked within core team to streamline business processes and internal controls, resulting in scalable and detailed set of procedures.
• Hired, trained and managed revenue department team members and developed engaged, high-functioning performers.
• Calculated and reconciled monthly screening revenue in accordance with established corporate terms.
• Functioned productively in matrix organization across organizational levels and organized and prioritized responsibilities to meet commitments.
• Recruited, interviewed, hired and trained more than 100 employees and implemented mentoring program to promote positive feedback and engagement.
• Developed strategic plans for day-to-day operations.
• Identified improvement changes regarding key processes for internal controls.
• Supported Senior Leadership within Admission Services with special projects and additional job duties.
• Reviewed historical records, current operational data and forecasting information to identify and capitalize on system enhancement opportunities.
• Developed metrics for Reverification objectives, supporting reduction of High Void and Rebills.

Key Projects

• Overview: Centralize and optimize request of insurance changes for our patients coverage within one place for 4 Reverification departments. This included more than 80 various reports to identify coverage published monthly for reverification of coverage as well as coordinate and organize 15 departments (over 400 users) requesting changes of insurance at enterprise level. Moreover, general oversight and development of the platform within PowerApps working closely with IT Analysts and coordinating other subject matter experts for best possible product to report all patients change of insurance. Goals were to minimize duplication of requests, provide visibility to users submitting requests, reporting to Sr Leaders at an enterprise level, reduce turnaround time. Results were 68% reduction turnaround time for insurance changes, 65% decrease in invalid requests from week 1 to week 6 , 20% reduction in duplicate requests and, centralized metrics for all insurance change requests
• Health Plan Initiative: Developed a program to reduce submission of Wrong Health Plans allocated at the time of verification. Identify obstacles throughout the enterprise and reduce data point references by which a verifications Patient Account Representative is required to look prior to selecting a health plan. Moreover, implement a checks and balances through existing and new reporting as well as, an initial Supervisor review and approval process for high-risk payers. Results developing a team of Subject Matter Experts across the enterprise to collaborate high risk payer nuances causing >50k VRBs (Void & Rebills), initially developing more than 60 payer/health plan tables as a result of team collaboration, creation of a Realtime Report to capture incorrect health plans allocated in a current month state prior to billing and development of ARAging Report to capture health plans allocated incorrectly at the time of an insurance change in a prior month state. Capturing over 40 wrong health plans per month over 480 per year and preventing approximately $60m in loss in expected revenue as a result of incorrect billing and wrong health plan allocation as a result of payer nuances.

• Oversight of Reverification Department internal transition, development and restructure.
• Departmental growth from 12 with tenure average of 90 days to 17of staff with tenure average of 2 years.
• Proved successful working within tight deadlines and fast-paced atmosphere.
• Prepared variety of different written communications, reports and documents.
• Resolved conflicts and negotiated mutually beneficial agreements between parties.

• Manage the daily facets of eight verification PARs.
• Identify & resolve insurance issues to minimize revenue impact for our business and patients.
• Form relationships throughout the company.
• Reconcile internal reports daily, weekly and monthly.
• Develop necessary tools to increase efficiencies and productivity.
• Responsible for new hire training and continuous training of existing employees.
• Support Supervisor with various needs and tasks.

• Proficient in Verification of patient insurance
• Identify & resolve issues communicated by insurance companies and internal business partners.
• Ensure accuracy & timely completion of patient verifications.
• Organize and update incoming volume of patient case load for billing.

• Established positive and effective communication among unit staff and organization leadership, reducing miscommunications and missed deadlines.
• Identified and resolved unauthorized, unsafe or ineffective practices.
• Set, enforced and optimized internal policies to maintain responsiveness to demands.
• Devised processes to boost long-term business success and increase profit levels.
• Partnered with vendors and suppliers to effectively manage and budget.
• Planned and resourced personnel and logistics for operations component exercises resulting in highly trained personnel ready to act quickly in critical roles.
• Investigated and resolved departmental non-conformances.
• Identified appropriate marketing channels and target customers for campaigns.
• Wrote engaging and successful marketing, advertising and website copy.
• Developed creative design for print materials, brochures, banners and signs.
• Created digital image files for use in digital and traditional printing methods.
• Designed website layouts, templates and unique branded looks.
• Applied creative expertise to present marketing concepts.

Key Project
McDonald’s Refurbishment
Overview: Tasked with coordination of refurbishing McDonald's playground, external signs, exterior walls and more. Project was sold at $1m with the budget allotted at 25% of project cost.
Results:
o Achieved project at 15% of the projected budget.
o Successfully organized timely out of state support for onsite Technicians.