TIFFANY L. ARZOLA
Killeen,Texas
Summary
Qualified Medical Assistant with 8 years’ experience, and over 15 years in the medical field. Qualified in fast paced medical office, along with experience on a Military Air Force Base. Proven to be an asset to local police department and an accomplished Supervisor in a Medical Office, Paraprofessional, Registration Clerk and Patient Relations Coordinator with experience ensuring high standards of culturally competent care for a wide variety of patients with diverse needs. Superior computer skills and telephone etiquette. Personable and professional under pressure.
Overview
9
9
years of professional experience
Work History
Account Specialist
Orbit Billing Solutions
04.2022 - Current
- Monitor over 50 service referrals for Applied Behavior Therapy, Speech Therapy, and Mental Health Therapy daily.
- Contact providers and clients for documents needed for referrals
- Verifies health insurance eligibility and obtains benefit information
- Follow-up with insurance companies to resolve issues
- Requests pre-authorization for scheduled visits and procedures
- Reviews clinical documentation to ensure it supports insurance requirements for approval
- Accurately notates account with actions taken for pre-certification
- Contacts insurance carriers to obtain benefit coverage, policy limitations, authorization/notification, and pre-certifications for patients
- Collaborates with internal departments to provide account status updates, coordinate resolution of issues and appeal denied authorizations
- Follows up on pending authorization requests in timely manner
- Ensures all services have prior authorizations and updates patients on their pre-authorization status
- Recorded accurate and efficient records in customer database.
- Notifies ordering providers if authorization/certification is denied
- Answers call from providers, patients and insurance companies related to authorization/pre-certification requests
- Perform additional duties as assigned.
- Set up new customer accounts and updated existing profiles with latest information.
Assistant Office Manager
Behavioral Billing
08.2021 - 03.2022
- Participate in development of internal credentialing processes for over 10 Mental Health providers.
- Keep records in licenses, credentials, and insurance contracts
- Maintain individual provider files to include up to date information needed to complete required governmental and commercial payer credentialing applications
- Maintain internal provider grid to ensure all information is accurate and logins are available
- Update each provider’s CAQH database file timely according to schedule published by CMS
- Complete credentialing applications to add providers to commercial payers
- Complete re-credentialing applications for commercial payers
- Work closely with Revenue Cycle Director and billing staff to identify and resolve any denials or authorization issues related to provider credentialing
- Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases
- Other duties as assigned
- Post payments for billing
- Contact insurance companies to get payment status, claim status and request EOBs
- Complete EFT and ERA enrollment for providers
- Assist in training new employee's
- Verify insurance benefits
- Help train employees with necessary task
- Write authorization appeal letters
- Perform additional duties as assigned.
- Created and updated physical records and digital files to maintain current, accurate, and compliant documentation.
- Transferred and directed phone calls, guests, and mail to correct staff members.
- Delivered top-notch administrative support to office staff, promoting excellence in office operations.
- Created and updated records and files to maintain document compliance.
- Conferred with insurance company representatives to expedite payments and resolve filing issues, keeping aging balances low and office finances strong.
Supervisor
Griner Medical Group
03.2021 - 07.2021
- Supervised 6-8 employees.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Handled customer complaints, resolved issues, and adjusted policies to meet changing needs.
- Monitored workflow to improve employee time management and increase productivity.
- Evaluated employee performance and coached and trained to improve weak areas.
- Achieved results by working with staff to meet established targets.
- Maintained compliance with company policies, objectives, and communication goals.
- Mentored newly hired employees on operating equipment and safety and developed training manual to use for reference.
- Enforced rules and regulations outlined in company manual to set forth expectations comprehensibly and consistently.
- Developed and implemented customer service policies to enhance satisfaction.
- Evaluated staff performance and provided coaching to address inefficiencies.
- Collected, arranged, and input information into database system.
- Developed effective improvement plans in alignment with goals and specifications.
- Hire and train new employees.
Patient Relations Coordinator
Griner Medical Group
07.2019 - 07.2021
- Verified patient insurance eligibility and entered patient information into system.
- Answered incoming calls, scheduled appointments and filed medical records.
- Provided excellent customer service to patients and medical staff.
- Greeted and assisted patients with check-in procedures.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Followed document protocols to safeguard confidentiality of patient records.
- Facilitated communication between patients and various departments and staff.
- Trained new staff on filing, phone etiquette and other office duties.
- Responded to inquiries by directing calls to appropriate personnel.
- Compiled and maintained patient medical records to keep information complete and up-to-date.
- Delivered support to medical staff in completion of patient paperwork.
- Worked with patients to ascertain issues and make referrals to appropriate specialists.
- Precisely completed appropriate claims paperwork, documentation, and system entry. Completion of FMLA, Katie Beckett forms, Physician Statements, return to work forms, short term disability forms, VA claims paperwork, hospice certifications, emergency response action plans, and assisted living forms
- Monitor Diabetic Mellitus shoe paperwork
- Complete No Show Fee encounters and update charts for over 20-30 patients daily.
- Scan in reminder, warning, and dismissal letters, update charts, and mail letters to over 50 patients weekly.
- Update over 20-30 charts for dismissed patients weekly. Send out task to appropriate personnel. Process dismissal letters
- Assist referral department in processing 100 over referrals daily upon request.
Clerical Administration
Griner Medical Group
06.2014 - 07.2019
- Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
- Collect co pay, co-insurance fees, collect balances, collection balance, and minimum payments for sick visits and rechecks
- Provided clerical support, addressing routine, and special requirements.
- Verify patients’ eligibility and claims status with insurance agencies
- Review and update charts
- Provided clerical support to company employees by copying, faxing, and filing documents.
- Interacted with customers by phone, email, or in-person to provide information.
- Maintained organized files and stocked supplies to support team needs and maximize performance
- Responded to inquiries from callers seeking information
Education
Medical Assistant Diploma - Medical Assistant
Everest Institute - Grand Rapids
Kalamazoo, MI05.2007
High School Diploma -
Valdosta High School
Valdosta, GA05.2001
Skills
- Supervisor
- Certified Notary (GA)(TX)
- Medical Assistant
- Patient Relations Coordinator
- Pharmacy Technician
- EMR Proficient
- Patient referral expert
- Credentialing Specialist
- Clerical Support
- Schedule Coordination
- Information Confidentiality
Timeline
Account Specialist
Orbit Billing Solutions
04.2022 - Current
Assistant Office Manager
Behavioral Billing
08.2021 - 03.2022
Supervisor
Griner Medical Group
03.2021 - 07.2021
Patient Relations Coordinator
Griner Medical Group
07.2019 - 07.2021
Clerical Administration
Griner Medical Group
06.2014 - 07.2019
Medical Assistant Diploma - Medical Assistant
Everest Institute - Grand Rapids
High School Diploma -
Valdosta High School
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