Tiffany Strunk, BSN, RN
Donnellson
Summary
Experienced Registered Nurse with over 10 years in care coordination, case management, and chronic disease management. Specializes in telephonic patient engagement and interdisciplinary collaboration while addressing social determinants of health. Focused on improving patient outcomes and reducing hospital readmissions through tailored care plans and patient education.
Overview
9
9
years of professional experience
Work History
Claims Resolution Specialist
illumifin
Remote
07.2024 - Current
- Analyze and resolve claimant complaints through critical analysis of all medical records along with policy language.
- Request appropriate documentation needed for complaint review from respective departments.
- Attend Claims Consult Team and/or client when applicable for complex appeal decisioning and/or complaint decisions.
- Complete root cause analysis and provide feedback to supervisors when deviations found.
- Review all responses to complaints for approval prior to mailing.
- Present monthly PowerPoints on claim summaries.
- Implement process improvements to enhance efficiency in claims resolution.
- Collaborated with other departments to obtain additional information needed for claim resolution.
- Initiate contact with customers by phone or mail concerning complaint status updates.
- Prepared detailed reports summarizing all activities pertaining to each claim.
- Adhered to established workflow processes and timelines in order to meet performance goals.
RN CMI, promoted April 2024 to RN CMII, CRT
illumifin
Remote
02.2022 - Current
- Review and obtain supporting medical records and determine claimant eligibility.
- Prepare communications to clients and claimants related to eligibility.
- Complete plan of care update when modifications to the plan of care arise.
- Monitor and complete reports as assigned by leadership.
- Attend case conferences as necessary to assist in determining claimant eligibility and other necessary meetings as assigned.
- Meet production and quality goals as established by leadership.
- Assist with claims resolution items as assigned by leadership for complex claims.
- Provide training as assigned by leadership to co-workers.
RN Home Health/Hospice Case manager
Southeast Iowa Regional Home Health Care (formerly GRMC)
09.2021 - 02.2022
- Deliver care and education to patients utilizing the nursing process of assessment, planning, intervention, implementation, and evaluation in coordination with other health team members for home health and Hospice.
- Provided high quality care to the following adult and pediatric patient populations in their homes, assisted living, long term-care facilities and the hospice house: Cardiac/ Acute Myocardial Infarction ( AMI ), Vascular, Hemodynamic Monitoring, Endocrine, Renal, Pulmonary, and provided end of life care to patients with a variety of diagnoses.
- Effectively interacted with the patient, significant others, and other health team members while maintaining high standards of professional nursing.
- Obtained prior authorization for insurance coverage, facilitating timely patient care through knowledge of medical billing processes.
- Provided coverage for home health supervisor during vacations, ensuring continuity of care.
- Rotated weekend, night, and holiday on-call shifts with staff to ensure comprehensive patient coverage.
Nurse/Nurse Manager
Southeastern Renal Dialysis
10.2020 - 09.2021
- Responsible for all clinical aspects of a dialysis center's operation, including providing and overseeing patient care and supervising clinical staff.
- Ensure patient education and overall satisfaction.
- Complete staff scheduling and payroll as well as manage vaccine needs and monthly audits for staff.
- Participate in manager meetings, quality and NHSN.
- Complete provider rounds as assigned including completing orders and administering medications to patients as well as placing patients on treatment utilizing assessment skills along with infection control and correct technique and protocol for cannulation and dialysis machine operation.
- Be aware of dialysis water room testing and normal ranges.
RN Home Health/Hospice Case manager
GRMC
04.2017 - 10.2020
- Delivered care and education to patients utilizing the nursing process of assessment, planning, intervention, implementation, and evaluation in coordination with other health team members for home health and Hospice.
- Provided high quality care to the following adult and pediatric patient populations in their homes, assisted living, long term-care facilities and the hospice house: Cardiac/ Acute Myocardial Infarction ( AMI ), Vascular, Hemodynamic Monitoring, Endocrine, Renal, Pulmonary, and provided end of life care to patients with a variety of diagnoses.
- Effectively interacted with the patient, significant others, and other health team members while maintaining high standards of professional nursing.
- Rotates weekend, night, and holiday on call with staff to facilitate adequate coverage for all patients.
Education
Bachelor of Science - Nursing
Chamberlain University
Chicago, Illinois04-2026
Associate of Applied Science - Nursing
Southeastern Community College
West Burlington, Iowa05-2013
High School Diploma -
Burlington High School
Burlington, Iowa05-2007
Skills
- Case management & Coordination
- Chronic Disease Management
- Telephonic Patient Engagement
- Social Determinants of Health (SDoH)
- Medicare/Medicaid Populations
- Discharge Planning
- Patient Education & Advocacy
- Interdisciplinary Collaboration
- EMR Documentation & Compliance
- Quality & Performance Metrics
- Client relations
- Multitasking, Adaptability & Problem-solving
Certifications And Licensures
- Registered Nurse, Iowa: Compact Nursing License, valid
- Mandatory Reporter Certification, valid
- Basic Life Support for Healthcare Provider, valid
Timeline
Claims Resolution Specialist
illumifin
07.2024 - Current
RN CMI, promoted April 2024 to RN CMII, CRT
illumifin
02.2022 - Current
RN Home Health/Hospice Case manager
Southeast Iowa Regional Home Health Care (formerly GRMC)
09.2021 - 02.2022
Nurse/Nurse Manager
Southeastern Renal Dialysis
10.2020 - 09.2021
RN Home Health/Hospice Case manager
GRMC
04.2017 - 10.2020
Bachelor of Science - Nursing
Chamberlain University
Associate of Applied Science - Nursing
Southeastern Community College
High School Diploma -
Burlington High School