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Tiffany User

@tiffanyuser15

Health Claims Examiner at COLINA INSURANCE LTD, processing medical claims and resolving coverage discrepancies.

Bahamas
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At COLINA INSURANCE LTD, I review and process medical claims, analyze records and bills for coverage eligibility, and investigate discrepancies, including denials and appeals.

I also worked in claims coordination and adjudication at GENERALI WORLDWIDE/EUROP ASSISTANCE/CORPORATE MEDICAL NETWORK (CMN) and FAMILY GUARDIAN INSURANCE CO. My work included reviewing health claims, preparing reports, and handling claims accounting tasks.

At MANGROVE CAY COMMUNITY CLINIC, I supported clinic administration through patient registration, document typing, transaction reporting, and monthly and quarterly reports. I also assisted the nursing department and helped facilitate community health events.

Alongside my claims and administrative work, I own MANGROVE MYSTIC SUSHI, preparing sushi and Asian cuisine with a Bahamian twist, and work as a freelance photographer through TAT PHOTOGRAPHY.

Experience

Work history, roles, and key accomplishments

MS
Current

Head Sushi Chef/Owner

Mangrove Mystic Sushi

Nov 2021 - Present (4 years 11 months)

Prepared Japanese sushi items and Asian cuisine with a Bahamian twist. Provided private dinner catering along with cake and pastry baking.

MC

Administrative Assistant

Mangrove Cay Community Clinic

Apr 2019 - Aug 2023 (4 years 4 months)

Handled patient registration, typing of documents, and reception duties. Completed monthly and quarterly reports and revenue deposits.

MA

Sea Sponge Fisher & Researcher

Mangrove Cay, Andros

Oct 2017 - May 2018 (7 months)

Collected and processed natural sea sponges. Conducted research, observation, and testing of sea sponges including growth and quality observation.

GN

Claims Coordinator

Generali Worldwide/Europ Assistance/Corporate Medical Networ

Oct 2015 - Oct 2017 (2 years)

Reviewed and uploaded health claims and handled customer service calls from providers. Performed accounting functions such as wire transfers, claims check disbursement, and account reconciliations.

FC

Claims Adjudicator

Family Guardian Insurance Co.

Jan 2014 - Oct 2015 (1 year 9 months)

Reviewed and processed health claims. Prepared end of month reports and facilitated claims check runs.

FC

Claims Accounting Administrator

Family Guardian Insurance Co.

Jan 2012 - Jan 2014 (2 years)

Processed and reported voids, reversals, and refunds. Performed account reconciliation.

FC

Group Operations Clerk

Family Guardian Insurance Co.

Jan 2009 - Jan 2010 (1 year)

Pre-logged health claims.

FC

Insurance Filing Clerk

Family Guardian Insurance Co.

Jan 2008 - Jan 2009 (1 year)

Sorted and classified information according to guidelines. Retrieved information from files in response to requests from authorized users.

HH

Pastry Chef

Home Sweet Home

Jun 2003 - Jan 2008 (4 years 7 months)

Prepared pastries and desserts.

PC

Care Giver

Private Care

Jun 2003 - Jan 2007 (3 years 7 months)

Provided caregiving services.

BS

Cashier

Buy For Less Food Store

Jan 2002 - May 2003 (1 year 4 months)

Issued receipts, refunds, credits, or change due to customers. Established or identified prices of goods and tabulated bills using calculators, cash registers, or optical price scanners.

MC

Clinic Administration Clerk

Mangrove Cay Clinic

Jun 2000 - Sep 2000 (3 months)

Performed administrative duties at the clinic.

Education

Degrees, certifications, and relevant coursework

City & Guilds Pitman logoCP

City & Guilds Pitman

Certificate, Bookkeeping & Accounting

2022 - 2023

Grade: First Class Pass

Earned a First Class Pass in Bookkeeping & Accounting Level 1 and Level 2 between December 2022 and June 2023.

ML

Microsoft Linkedin Learning

Certificate, Customer Service

Earned a Certificate in Customer Service Specialist in December 2020.

UO

United for Wildlife Organization

Certificate, Wildlife Conservation

Activities and societies: 8 honor badges

Earned a Certificate in Wildlife Conservation with 8 honor badges in March 2018.

University of Tasmania Open2Study logoUO

University of Tasmania Open2Study

Certificate of Achievement, Marine & Antarctic Science

Earned a Certificate of Achievement in Marine & Antarctic Science in September 2018.

New York Institute of Photography logoNP

New York Institute of Photography

Certificate, Photography

Earned a Certificate in Professional Photography in June 2018.

International College of Management (ICMS) Open2Study logoIO

International College of Management (ICMS) Open2Study

Certificate of Achievement, Management

Earned a Certificate of Achievement in Management in October 2018.

International Claims Association logoIA

International Claims Association

Fellowship, Life and Health Claims

Earned a Fellowship (Bachelor's level) in Life and Health Claims in March 2015.

LOMA Institute International logoLI

LOMA Institute International

Certificate, Underwriting

Earned a Certificate in Underwriting Life and Health Insurance in May 2015.

International Claims Association logoIA

International Claims Association

Associate, Life and Health Claims

Earned an Associate designation in Life and Health Claims in January 2014.

LOMA Institute International logoLI

LOMA Institute International

Associate, Life Management

Earned an Associate designation in Life Management in January 2013.

LOMA Institute International logoLI

LOMA Institute International

Associate, Customer Service

Earned an Associate designation in Customer Service in January 2011.

College of the Bahamas logoCB

College of the Bahamas

Certificate, Culinary Arts

Completed coursework in Cake & Pastry Making in June 2010.

MS

Mangrove Cay High School

High School Diploma, General Studies

Activities and societies: 7 B.G.C.S.E. Passes grade C & above; 6 Graduating Certificates; Valedictorian 2001

Earned a High School Diploma with 7 B.G.C.S.E. passes and was valedictorian in 2001.

Tech stack

Software and tools used professionally

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