Tiffany Distefano, CAC
Omaha,NE
Summary
Meticulous Revenue Cycle Manager and Medical Billing Specialist with strong background in continuous improvement and revenue performance analysis. Focused and organized with demonstrated success in achieving company goals through increased efficiency initiatives illustrated over 10 years of Medical Billing success. The end goal is to secure a position with a well-established organization with a stable environment that will lead to a lasting relationship.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Revenue Cycle Manager
City Ventures Health
08.2021 - 04.2023
- Supported collection team members with revenue cycle procedures and addressed issues.
- Reviewed historical records, current operational data and billing information to identify and capitalize on system enhancement opportunities.
- Monitored and guided revenue cycle operations.
- Assessed current revenue cycle procedures and implemented improvements to foster efficiency.
- Developed strategic plans for day-to-day financial operations.
- Evaluated and negotiated contracts to procure favorable financial terms.
- Completed financial reporting and analysis for billing revenue cycle.
- Created financial dashboards to provide insights into key performance indicators.
- Established internal audit procedures to validate and improve accuracy of financial reporting.
Revenue Cycle Manager
GS Labs, LLC - (Division Of City Ventures)
08.2021 - 04.2023
- Supported collection team members with revenue cycle procedures and addressed billing discrepancies.
- Evaluated and negotiated contracts to procure favorable financial terms.
- Developed strategic plans for day-to-day financial operations.
- Assessed current revenue cycle procedures and implemented improvements to foster efficiency.
- Created financial dashboards to provide insights into key performance indicators.
- Reviewed historical records, current operational data and forecasting information to identify and capitalize on system enhancement opportunities.
- Completed financial reporting and analysis for billing revenue cycle.
- Researched accounts and completed due diligence to resolve collection problems.
- Negotiated to collect balance in full.
- Researched billing errors and discrepancies to initiate corrective action.
- Developed and documented collection procedures and policies to comply with government regulations.
- Trained new team members on scripts, company services, and collection strategies.
Collections Specialist
GS Labs, LLC
08.2021 - 04.2023
- Researched accounts and completed due diligence to resolve collection problems.
- Delivered exceptional customer service on collection calls and maintained calm and professional demeanor.
- Assisted in implementing procedures and policies to facilitate timely payments.
- Negotiated to collect balance in full.
- Initiated repossession process or service disconnection upon failure of other collection methods.
- Researched billing errors and discrepancies to initiate corrective action.
- Developed and documented collection procedures and policies to comply with government regulations.
- Trained new team members on scripts, company services, and collection strategies.
Insurance Coding and Billing Specialist
Quick Med Claims
12.2017 - 08.2021
- I’m a Certified Ambulance Coder (CAC)
- I handle emergency medical billing
- I code the services provided and submit the claims for payment.
INSURANCE CODING AND BILLING SPECIALIST
Physicians Laboratory Services
07.2016 - 12.2017
- EXPERIENCED IN POSTING PATIENT AND INSURANCE ACCOUNT PAYMENTS
- PROCESSING CLAIMS AND
- EOBS
- ADVANCED KNOWLEDGE WITH ICD-10 CODING FOR PATHOLOGY
- IN DEPTH KNOWLEDGE WITH
Precertification Specialist
MEDICARE GUIDELINES, Orthowest
08.2015 - 06.2016
- Experienced in certifying surgical procedures, diagnostic imaging requests, and injections by obtaining authorizations through the insurance companies
- Strong knowledge of ICD-9, ICD-10, and CPT-4 codes
- Experienced in precertification, prior authorizations, pre-determinations, and arranging Peer to Peer reviews.
Dedicated Customer Service Agent
Email Solutions Inc
09.2013 - 08.2015
- Providing outsourced scalable and efficient customer service as a dedicated agent
- My support services specialized in
- Medical technology/software, technical support and live dialogue in real time to customers via internet
- Direct outbound emailing, and mailing services
- Home In-home Caregiver/Companion
Med Care Manager
A Place At Home
08.2012 - 08.2013
- In-home caregiver/companion assisting elderly patients with ADL's and activities.
Med Care Manager
Brighton Gardens
01.2009 - 01.2013
- Responsible for dispensing daily medications to patients as needed and directed by
- Communicated with patients, ensuring that medical information was kept private.
- Established and maintained effective communication with staff, physicians and community organizations to promote high quality patient care.
- Also assisted patients with their ADL's and hygiene.
Education
Certification - Medical Coding & Billing Specialist
Herzing University
05.2015
Skills
- Commercial Insurance, Medicare and Medicaid
- Trizetto, GoRev, InSync, Claims MD, ZIRMED, Cerner, Intergy, Intergy EHR healthcare systems, Microsoft Word, and Excel
- Accounts Receivable
- Collections Specialist
- Claims Specialist
- Medical Billing Specialist
- CPT Coding
- ICD-9
- ICD-10
- ICD Coding
- HIPAA
- Insurance Verification
- EMR Systems
- Patient Care
- Home care
- Hospice care
- Accounting
- Highly skilled in maintaining strong relations with clients and patients
- Operational Efficiency
- Revenue Performance
- Strong knowledge of medical terminology
- Proficient in Cerner, Intergy, Intergy EHR, Microsoft Word, Outlook, and Excel
- SPECIAL SKILLS
- Excellent knowledge of ethics in the medical field
- Maintaining patient confidentiality
- Clear understanding of patient charting
- Functional knowledge of commercial insurance, Medicaid, and Medicare
- Great with time management and organization
- Sustain positive attitude through routine tasks
- Financial Reporting and Analysis
- Account Resolutions
- Manage Cash Flow
- Accounts Payable and Accounts Receivable
- Excellent Team Leadership
- Insurance Negotiation
- Spreadsheet Tracking
- Collections Actions
- Compliance Requirements
- Revenue Cycle Management
- Quality Improvement Plans
- Billing Cycle Performance
Certification
- Currently obtaining CPC - Certified Professional Coder
- Certified Ambulance Coder (CAC)
- Certified Nursing Assistant (CNA)
- Medication Aide
Timeline
Revenue Cycle Manager
City Ventures Health
08.2021 - 04.2023
Revenue Cycle Manager
GS Labs, LLC - (Division Of City Ventures)
08.2021 - 04.2023
Collections Specialist
GS Labs, LLC
08.2021 - 04.2023
Insurance Coding and Billing Specialist
Quick Med Claims
12.2017 - 08.2021
INSURANCE CODING AND BILLING SPECIALIST
Physicians Laboratory Services
07.2016 - 12.2017
Precertification Specialist
MEDICARE GUIDELINES, Orthowest
08.2015 - 06.2016
Dedicated Customer Service Agent
Email Solutions Inc
09.2013 - 08.2015
Med Care Manager
A Place At Home
08.2012 - 08.2013
Med Care Manager
Brighton Gardens
01.2009 - 01.2013
Certification - Medical Coding & Billing Specialist
Herzing University
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