Summary
Overview
Work History
Education
Skills
Custom
Timeline
Generic

Tiffany Tarpley-Young

Philadelphia,PA

Summary

Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.

Overview

17
17
years of professional experience

Work History

Insurance Verification Specialist

Rothman Orthopaedics
09.2023 - Current
  • Demonstrate high level of professionalism and attention to detail in all aspects of insurance verification specialist role, consistently exceeding performance expectations. Assure timely verification of insurance benefits prior to patient procedures or appointments.
  • Update patient records with accurate, current insurance policy information.
  • Make contact with insurance carriers to discuss policies and individual patient benefits.
  • Maintain strong knowledge of basic medical terminology to better understand services and procedures.
  • Collaborate with team members to resolve discrepancies in insurance verification.
  • Member of development team for EMR systems single platform conversion. Providing data for predetermined insurance verification indicators to allow for acceptance or rejection by Real Time Eligibility processes.

Insurance Verification Supervisor

Rothman Orthopaedics
01.2023 - 08.2023
  • Oversaw daily operations of department, ensuring smooth workflow and timely completion of tasks.
  • Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
  • Resolve patient grievances as needed.
  • Provided recommendations to manager on department members performance reviews.
  • Collaborated with other departments to achieve organizational goals, fostering teamwork across various functions.

PATIENT REGISTRATION/INSURANCE VERIFICATION LEAD

ROTHMAN ORTHOPAEDICS
04.2014 - 12.2022
  • Responsible for accurate collection demographic information and insurance for orderly registration of patient prior to services being rendered
  • Knowledge and use of Navi Net; All Scripts Payer Path; Other Insurance verification platforms
  • Request for and retrieval of specialist referrals and prior authorizations
  • Knowledge of CPT and ICD 10 codes for use of request for referrals and authorizations request under direct supervision of clinical staff.

Patient Access Coordinator

Rothman Orthopaedics
04.2012 - 04.2014
  • Operator Representative: Correct filtration of calls for company and transmittal of electronic telephone encounter messaging to administrative and clinical staff
  • Scheduling Representative: Responsible for scheduling of patient appointments efficiently within a timely manner for Orthopedic Specialty Practice with knowledge of specific physician protocols.
  • Contributed to a positive work environment by providing support and assistance to colleagues during peak periods or staff shortages.
  • Managed high volumes of inbound calls while addressing scheduling requests, appointment confirmations, prescription refills, and general inquiries professionally.

Customer Service Team Lead

Diverstaff
05.2010 - 04.2012
  • Provide oversight of call center staff for assigned contracts under ACS' Emergency Medical Services (EMS) group
  • Manage 35-member Call Center and Third Part Billing operation
  • Direct supervision of 6-customer service representative to ensure that tasks are efficiently completed in a timely manner
  • Work closely with ACS management to identify and improve efficiency
  • Assist with human resources responsibility
  • Disciplinary action/follow up, timekeeping and interviewing potential employees)
  • Manage daily records of reports system for various contracts
  • Performed end of month revenue reconciliation tasks.

ACCOUNT RECEIVABLE REPRESENTATIVE

PRWT
11.2007 - 04.2010
  • Managed Data Entry Log of payments received from patients, representatives of patients and insurance companies including adjustment of accounts according to contracts with insurance providers
  • Responsible for the correct sending of HCFA claims weekly to various insurance companies for reimbursement
  • Managed inquiries from patients and insurance provider/employers (i.e
  • Updating patient insurance, problem resolution, appeal processing ; updated patient/responsible party demographics)
  • Responsible for updating procedure code and charges for services rendered to patients, to insure correct billing totals and reimbursement collection
  • Analyzed Insurance EOBS's for the processing of denials, to be able to resolve any issue present and the resubmission of claims
  • Audited the reading of Patient Records/Repots to insure proper ICD9 coding is utilized.
  • Streamlined billing processes for improved efficiency and reduced errors.

CUSTOMER SERVICE REPRESENTATIVE

PRWT
11.2007 - 04.2010
  • Performed daily mailroom procedures for PRWT Emergency Medical Services (EMS) group
  • Applied USPS rejected mailings to customers and routed properly.

Education

HIGH SCHOOL DIPLOMA -

PHILADELPHIA HIGH SCHOOL FOR GIRLS
Philadelphia, PA
06.2004

Skills

  • Customer Service
  • Team Motivation
  • Time Management
  • Revenue Generation
  • Peer Management

Custom

Available upon request.

Timeline

Insurance Verification Specialist

Rothman Orthopaedics
09.2023 - Current

Insurance Verification Supervisor

Rothman Orthopaedics
01.2023 - 08.2023

PATIENT REGISTRATION/INSURANCE VERIFICATION LEAD

ROTHMAN ORTHOPAEDICS
04.2014 - 12.2022

Patient Access Coordinator

Rothman Orthopaedics
04.2012 - 04.2014

Customer Service Team Lead

Diverstaff
05.2010 - 04.2012

ACCOUNT RECEIVABLE REPRESENTATIVE

PRWT
11.2007 - 04.2010

CUSTOMER SERVICE REPRESENTATIVE

PRWT
11.2007 - 04.2010

HIGH SCHOOL DIPLOMA -

PHILADELPHIA HIGH SCHOOL FOR GIRLS

Similar Profiles

CREATE PROFILE
Tiffany Tarpley-Young