Tiffany J. Thomas

**** *. ****** ***** **** #****

Plano, TX 75074

#214-***-****

ad3dwj@r.postjobfree.com

Case Management:

Profile:

·Qualified accounts management skills of 10 years with helping and assisting patients.

· Knowledge of claims, revenue cycling, and health information management.

· Expert in explaining and verifying benefits with patients and Providers.

Employment:

CerpassRx 07/2023 – 12/2023

Patient Advocate

Answer inbound calls and assisting Patients with getting savings for their medication

Call the pharmacy to have denied claims reprocessed for payment

Submit claims for prior authorizations and completing overrides to have claims paid correctly

IRS 02/2023 – 06/2023

Tax Examiner

Examine all 1040X tax forms for businesses

Verified tax information

Corrected any mathematical errors and rerouted certain forms to the correct department for reworked.

Veteran Government Solutions 03/2022 – 12/2022

Benefit Support Specialist

Assist TRICARE beneficiaries with their healthcare plan copays and deductibles/Out of Pocket costs.

Assist with Utilization review and Case management processing for Providers.

Assist with claims development and filing, then escalate the claims for further review when needed.

Tailored Management/Cardinal Health 09/2021 – 03/2022

Care Coordinator

Assisted with managing patients’ accounts and financial assistance to receive help with their medication.

Answer any questions or concerns from the PT or HCP office to process enrollment.

Explain the types of programs and the different appeals and procedures.

Healthcare Support/ Walgreens Specialty Pharmacy 12/2019 – 04/2020

Customer Service Specialist

● Assisted customers with ordering their specialty medications

● Modified their shipping and expedited certain medications

● Notated the account per the action taken on the call. Escalated the call to upper management when I could no longer assist the customer.

United Healthcare Group 10/2016 – 10/2018

Strategic Account Specialist

Managed patient accounts and verified benefits with Providers.

Processed and reviewed Provider claims for billing errors, also explained the appeal/grievance process when outside of timely filing.

Initiated referral and prior authorization for Provider, also verified CPT and HCPS codes for different procedures.

Education:

Fairley High School, Memphis, TN 1999 - 2003

Bryant & Stratton College, Buffalo, NY 2023 - Current

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