Summary
Overview
Work History
Education
Skills
Accomplishments
Certification
Timeline
Generic

Tiffany Judd

Durham,NC

Summary

Dynamic Sr Provider Service Specialist with a proven track record at Blue Cross NC, excelling in enhancing provider satisfaction and operational efficiency. Skilled in medical claims processing and exceptional interpersonal communication, I implemented process improvements that reduced wait times significantly while fostering a collaborative team environment. Committed to delivering outstanding service and support.

Experienced leader with strong background in guiding teams, managing complex projects, and achieving strategic objectives. Excels in developing efficient processes, ensuring high standards, and aligning efforts with organizational goals. Known for collaborative approach and commitment to excellence.

Equipped with strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm.

Detail-oriented individual with exceptional communication and project management skills. Proven ability to handle multiple tasks effectively and efficiently in fast-paced environments. Recognized for taking proactive approach to identifying and addressing issues, with focus on optimizing processes and supporting team objectives.

Overview

17
17
years of professional experience
1
1
Certification

Work History

Patient Service Associate

Duke Health
10.2024 - Current
  • Facilitated patient check-in processes, ensuring accurate data entry and streamlined operations.
  • Coordinated appointment scheduling, optimizing staff productivity and patient flow efficiency.
  • Managed on average 15 medical history verification applications, enhancing accuracy of patient records and reducing billing discrepancies.
  • Conducted follow-up communications with patients, improving satisfaction and adherence to care plans.
  • Trained 1 new staff on office protocols and customer service standards, fostering a collaborative team environment.
  • Implemented process improvements that reduced wait times for patients by enhancing workflow strategies.
  • Promoted a welcoming atmosphere by greeting patients upon arrival, quickly addressing their needs, and answering questions clearly.
  • Maintained confidentiality by properly handling sensitive patient information in accordance with HIPAA guidelines.
  • Supported clinical staff by organizing and maintaining patient records for easy access and updated documentation.
  • Managed multiple phone lines, addressing patient inquiries and directing calls to appropriate departments as needed.
  • Reduced errors in data entry by diligently verifying information on forms prior to submission into the system.
  • Processed payments using cash and credit cards, maintaining accurate records of transactions.
  • Resolved customer complaints using established follow-up procedures.

Sr. Provider Service Specialist

Blue Cross NC
11.2008 - Current
  • Assisted providers with inquiries, ensuring timely and accurate information delivery.
  • Supported team in daily operations, enhancing overall service efficiency.
  • Learned and utilized company systems to manage customer interactions effectively.
  • Collaborated with colleagues to improve service protocols and workflow processes.
  • Addressed provider concerns with empathy, fostering positive relationships and satisfaction.
  • Improved customer satisfaction by addressing and resolving service-related issues promptly and professionally.
  • Consistently met or exceeded performance metrics related to service quality, response time, and customer satisfaction scores.
  • Achieved high levels of productivity by optimizing workload management methods and prioritizing tasks according to urgency.
  • Cultivated strong relationships with clients through excellent communication skills and genuine concern for their needs, leading to increased client retention rates over time.
  • Streamlined service processes for quicker response times, enhancing overall customer experience.
  • Managed service specialist team, fostering a positive work environment and encouraging teamwork to achieve desired results.
  • Mentored junior staff members on best practices regarding service excellence while modeling exemplary behavior at all times.
  • Proactively identified opportunities for improvement within the service delivery process, implementing changes that led to tangible benefits for both customers and employees alike.
  • Collaborated with team members to develop new strategies for improving service quality and efficiency.
  • Delivered exceptional customer service by promptly addressing inquiries and resolving issues.
  • Addressed customer concerns with empathy, fostering positive relationships and satisfaction.
  • Maintained organized records of customer interactions for future reference and analysis.

Education

High School Diploma -

Hillside High School
Durham
05-2004

Skills

  • Exceptional interpersonal and relationship building skills
  • Excellent written and verbal communication skills
  • Ensure efficiency of reporting data for supported business area and for trend analysis
  • Proactively identify trends and issues and recommend areas for improvement
  • Utilize probing and creative problem solving and critical thinking skills
  • 75 WPM typing speed
  • Analyze complex and ambiguous information to resolve customer inquiries on first contact
  • Ability to work independently and work on an empowered team that does peer training, metric management, quality audits, conflict resolution, and coaching development
  • Navigate multiple computer systems and platforms Also include PowerPoint, Microsoft word, Internet, Office
  • Broad Knowledge of medical claims processing
  • Train/coach others on appropriate systems
  • Medical Terminology

Accomplishments

  • Extensive Customer Service Training- since 2008 and ongoing
  • Benefits Trained- since 2009 and ongoing
  • Claims Adjustment for SHP, Insured/ASO and IPP Host- 2017
  • Managed training and leaderships roles
  • 2018 Service Excellence Award
  • Resolved Medical Policy issue with compression Hose-2017
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Documented and resolved SHP Pricing and contract issue which led to claims being updated and adjusted.

Certification

  • NC Insurance Producer License in Health, Accident and Sickness -06/27/25 to 10/2027
  • NC Insurance Producer License in Medicare Supplement and Long Term Care 06/27/25 to 10/2027
  • CPR/AED Certified 11/22/2024-11/2026

Timeline

Patient Service Associate

Duke Health
10.2024 - Current

Sr. Provider Service Specialist

Blue Cross NC
11.2008 - Current

High School Diploma -

Hillside High School

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Tiffany Judd