Tiffany Tutwiler- Mahon
Chicago
Summary
Dynamic, customer-focused professional with over 15 years of experience in healthcare, customer service, management, medical collections, and specialty pharmaceuticals. Recognized for a strong work ethic, adaptability, and exceptional interpersonal skills, consistently delivering outstanding service while embracing new challenges. Expertise as a REMS and Reimbursement Specialist includes managing complex processes, resolving issues, and ensuring compliance with regulatory requirements to minimize errors. Proven ability to efficiently handle difficult tasks while demonstrating strong analytical skills and meticulous attention to detail in optimizing strategies.
Overview
13
13
years of professional experience
Work History
Virtual Reimbursement Specialists (Enflonsia Vaccine)
Syneos Health
08.2025 - Current
- Act as the primary liaison for healthcare providers, pharmacies, payers, and patients, managing all aspects of reimbursement, benefit investigation, and access support for the Enflonsia vaccine.
- Perform comprehensive benefits investigations to determine insurance coverage, copay requirements, and prior authorization criteria.
- Prepare, submit, and track prior authorizations and coverage exception requests, ensuring timely payer approval.
- Manage appeals and denials, collaborating with providers and payers to secure coverage and reduce treatment delays.
- Educate prescribers, pharmacists, and office staff on payer requirements, billing codes, and reimbursement policies.
- Provide patient support by connecting them with financial assistance programs, copay support, and bridge programs to minimize out-of-pocket costs.
- Document all case activity in CRM systems, ensuring compliance with HIPAA, company SOPs, and regulatory requirements.
- Escalate complex cases to field reimbursement managers or payer relations teams, driving timely resolution of access barriers.
- Maintain up-to-date knowledge of payer policies, coverage guidelines, and reimbursement trends, sharing updates with internal teams and stakeholders.
- Deliver positive customer experiences by responding promptly to inquiries and providing clear guidance throughout the reimbursement process.
Risk Mitigation Evaluation Specialists (REMS), Clozapine (CPMG)
Syneos Health
07.2024 - 07.2025
- Acted as the central liaison between prescribers, pharmacists, and patients, ensuring compliance with the Clozapine REMS program, facilitating uninterrupted patient access, and supporting adverse event reporting and regulatory requirements.
- Served as the primary point of contact for prescribers, pharmacists, and patients, providing guidance on requirements to ensure understanding and compliance with FDA mandated REMS programs.
- Managed inbound and outbound communications, providing clear guidance, education, and support regarding REMS requirements and documentation processes.
- Triaged adverse events and product complaints, entering accurate, timely data into regulatory systems in accordance with program guidelines and Good Documentation Practices (GDP).
- Performed follow ups with stakeholders to collect missing or updated information, ensuring accurate and complete data capture across CRM and specific program databases.
- Conducted case investigations and follow-ups with healthcare providers and patients to collect critical information for adverse event documentation.
- Maintained high standards of compliance and customer satisfaction by adhering to internal SOP's, client protocols and regulatory standards.
- Participated in ongoing training and process improvements demonstrating agility and a commitment to continue learning.
- Able to troubleshoot IT/ technical inquiries.
Specialty Pharmacy Care Ambassador
Optum Frontier Therapies Specialty Pharmacy
09.2021 - 07.2024
- Served as personalized support and clinical advisor to patients using specialty medications, to ensure treatment adherence.
- Triaged adverse events and product issues for several specialty drug therapies.
- Managed inbound and outbound communications.
- Accurately updated demographics and medical history. Onboarded new patients, processed insurance, and prior authorizations.
- Proficiently processed and dispensed new prescriptions and refills for multiple specialty drug therapies. Scheduled deliveries, issued refunds and credits.
- Proactively contacted patients to refill medication and discuss medication adherence.
- Successfully completed ongoing training on both new and existing specialty drug therapies.
Collections /Client Service Manager
Hospital Management Services
01.2020 - 08.2021
- Managed day-to-day operations of the healthcare collections department, overseeing a team of collection agents to ensure productivity, compliance, and efficient debt recovery.
- Fostered strong relationships with healthcare providers, insurance companies, and third-party vendors, ensuring efficient communication and the timely resolution of outstanding claims.
- Implemented staff bonus programs.
- Managed accounts receivable, collections and credit activities.
- Conducted compliance audits.
Credit and Collections Manager
Hospital Management Services
01.2015 - 08.2020
- Managed debt collection operations to ensure timely and effective recovery of outstanding accounts.
- Developed and implemented collection strategies and policies to maximize recovery rates. Manage and supervise collection staff providing training, coaching, and performance evaluations.
- Monitored key performance indicators (KPIs) and prepare reports on collection activities and outcomes.
- Ensured compliance with all relevant laws, regulations, and industry standards.
Collections Manager
Southwest Credit
01.2013 - 01.2015
- Managed day-to-day operations of the collections department, overseeing a team of collection agents to ensure productivity, compliance, and efficient debt recovery.
- Trained, developed, and mentored new hires on company policies, procedures, and daily tasks.
- Upheld compliance, through mentoring and weekly call calibrations.
Education
Bachelor of Arts - Business Administration
Spelman College
Atlanta, GA05.1994
Skills
- Medical Terminology
- CRM software
- HIPAA
- CPT coding
- Drug Therapy
- Insurance prior authorization
- Salesforce
- Microsoft Office
- Customer Relationship Management (CRM)
- Health Information Management (HIM)
- Pharmacy
- Product Knowledge
- ICD-10
- Adverse Events
- PHI (Patient Health Information)
Timeline
Virtual Reimbursement Specialists (Enflonsia Vaccine)
Syneos Health
08.2025 - Current
Risk Mitigation Evaluation Specialists (REMS), Clozapine (CPMG)
Syneos Health
07.2024 - 07.2025
Specialty Pharmacy Care Ambassador
Optum Frontier Therapies Specialty Pharmacy
09.2021 - 07.2024
Collections /Client Service Manager
Hospital Management Services
01.2020 - 08.2021
Credit and Collections Manager
Hospital Management Services
01.2015 - 08.2020
Collections Manager
Southwest Credit
01.2013 - 01.2015
Bachelor of Arts - Business Administration
Spelman College