TIFFANY C. HARRIS
Summary
Healthcare professional with robust background in medical claims analysis and resolution. Adept at streamlining claim processing workflows and ensuring adherence to industry regulations. Valued team player with focus on collaboration and achieving optimal results, exhibiting flexibility to adapt to evolving demands. Proficient in medical coding, data analysis, and regulatory compliance, showcasing reliability and results-driven mindset.
Overview
8
8
years of professional experience
Work History
Medical Claims Analyst and Medical Biller
Springstone/ Lifepoint (previously Cornerstone )
04.2023 - Current
- Demonstrated a commitment to continuous improvement by actively seeking out opportunities for process optimization within the Medical Claims Analyst role.
- Verified insurance of patients to determine eligibility.
- Conducted comprehensive audits to identify inconsistencies and irregularities in medical claims data.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Responds to requests from insurance carriers,family members, and patients regarding account balance issues.
- Work with Utilization departments to ensure pre-certifications,certifications,and appeal are completed accurately and timely.
- Submit claims to insurance companies or other payers.
- Track status of claims and follow u p with insurance companies to ensure timely payment.
- Investigate and resolve discrepancies in billing,such as denials,errors,or delays.
Medical Billing and Collection Specialist
Cornerstone Behavior Healthcare
08.2021 - Current
- Expedited and maximized payment of insurance medical claims by contacting insurance payers by phone or website
- Resolved all denials and requests for information
- Coordinated correspondence with insurance carriers
- Worked aged accounts receivable report
- Submitted professional clinical and financial appeals to payor in timely manner.
- Reduced claim denials by diligently reviewing patient records for correct coding and billing information.
Billing and Collections Coordinator
Texas Digestive Disease Consultants
02.2018 - 03.2020
- Process Insurance denials, written appeals and corrected claims.
- Review payer rules to understand reason for denials.
- Interpret progress notes, operative notes and discharge summaries.
- Resolved client billing problems by collecting direct payments and setting up payment plans.
- Excellent Customer Service and Patient Skills
- Obtained PreCertifications and PreAuthorizations for Procedures.
- Supported accounts receivable department in reconciling customer accounts, ensuring accurate payment application and prompt resolution of discrepancies.
- Negotiated settlements with delinquent account holders, securing favorable outcomes for both parties and reducing overall writeoffs.
Billing Specialist
Behavior Healthcare Group
02.2017 - 11.2017
- Met weekly billing and collections quotas by diligently handling assignments and pursuing payments.
- Corrected system errors with proactive verification of billing information.
- Handled eligibility problems with good investigation skills and analytical approach to tracing and resolving various issues.
- Posted payments, created billing statements.
- Researched and resolved billing discrepancies to enable accurate billing.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
Education
Patient Care Technician -
TENNESSEE TECHNOLOGY CENTER
Nashville, TN01-2014
High School Diploma -
ANTIOCH HIGH SCHOOL
01.1993
Skills
- Claims processing proficiency
- HIPAA compliance
- Training and mentoring
- Medical terminology
- EHR Systems: EPIC,Wellsky,Meditech,SSI,Assurance,Waystar
- Insurance Verification
- Healthcare Coding (ICD-10 CPT)
- Pre-Authorization
- Referrals
Timeline
Medical Claims Analyst and Medical Biller
Springstone/ Lifepoint (previously Cornerstone )
04.2023 - Current
Medical Billing and Collection Specialist
Cornerstone Behavior Healthcare
08.2021 - Current
Billing and Collections Coordinator
Texas Digestive Disease Consultants
02.2018 - 03.2020
Billing Specialist
Behavior Healthcare Group
02.2017 - 11.2017
High School Diploma -
ANTIOCH HIGH SCHOOL
Patient Care Technician -
TENNESSEE TECHNOLOGY CENTER
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