Tiquana Riley

Skills

* Medical Billing & Coding
* Healthcare Revenue Cycle Management
* Claims Adjudication
* Claims Processing & Resolution
* Denial Management & Appeals
* Accounts Receivable
* Payment Posting & Reconciliation
* Insurance Verification
* Prior Authorization
* Provider Credentialing
* Provider Enrollment
* Contracting & Payer Relations
* Reimbursement Analysis
* Revenue Cycle Analysis
* Fraud Detection & Investigation
* Claims Investigation
* Compliance & Regulatory Review
* Policy & Procedure Interpretation
* Documentation & Records Management
* Data Analysis & Reporting
* Quality Assurance & Auditing
* Process Improvement
* Root Cause Analysis
* Research & Problem Solving
* Case Management
* Customer Service
* Stakeholder Communication
* Confidential Information Handling
* Microsoft Office Suite
* Excel & Data Tracking
* Healthcare Information Systems
* Electronic Health Records (EHR)
* Multi-Location Operations
* Workflow Management
* Project Coordination
* Time Management
* Attention to Detail
* Written & Verbal Communication
* Confidentiality & Data Privacy
* Independent Decision-Making
* Cross-Functional Collaboration
* Training & Staff Support
* Administrative Operations

About

Experienced healthcare revenue cycle and administrative professional with a strong background in medical billing, coding, reimbursement, provider credentialing, claims resolution, denial management, and healthcare operations. Experienced in supporting multi-location healthcare organizations, coordinating with providers and payers, analyzing accounts and payment trends, resolving complex billing issues, and improving revenue-cycle processes.

Brings additional experience in fraud investigation, claims adjudication, regulatory compliance, records review, and analytical decision-making. Skilled at researching discrepancies, interpreting policies and regulations, documenting findings, maintaining confidentiality, and communicating effectively with healthcare providers, patients, insurance representatives, and internal leadership.

Known for being detail-oriented, organized, analytical, and able to manage competing priorities while meeting productivity and accuracy expectations. Proficient in healthcare information systems, electronic records, billing platforms, Microsoft Office, data tracking, reporting, and process improvement. Seeking to apply extensive healthcare, administrative, investigative, and analytical experience in a mission-driven federal government position.