Tiffany Pulcine

Revenue Cycle Management professional with 15+ years of progressive experience in hospital, radiology, and DME environments. Proven success leading billing teams, optimizing A/R performance, reducing denials, and improving reimbursement outcomes. Strong background in Medicaid/Medicare billing, payer relations, compliance, staff development, and process improvement. Recognized for driving operational efficiency while maintaining regulatory integrity and high-quality standards.

Patient Access Representative - Saint Peter's University Hospital

(2022-03)

• Support hospital revenue cycle operations through Medicaid and commercial payer billing for inpatient and outpatient services
• Process ATB inpatient claims for Medicaid, UHC, Cigna, Aetna, and Oxford
• Serve as backup for daily billing runs, remittances, deposits, and charity care submissions
• Perform high-dollar account follow-up, denials resolution, credits, and collections
• Collaborate cross-functionally to resolve discrepancies and reduce claim delays

Medicaid Patient Account Representative - University Radiology

(2021-10 - 2022-03)

• Managed NJ & NY Medicaid/HMO billing, including out-of-state claims
• Maintained productivity of 125–160 claims per day, exceeding departmental benchmarks
• Reduced aged A/R by 13%, contributing to measurable revenue improvement
• Partnered with coding and billing leadership to ensure accurate coding and maximum reimbursement
• Submitted corrected claims and voids through NJMMIS and EPACES

Medical Billing & Claims Supervisor - Community Surgical Supply

(2016-11 - 2021-10)

• Led and supervised a team of 8 billing professionals, overseeing hiring, onboarding, training, and performance management
• Reduced payment errors by 50% and denial rates by 65% through process optimization and staff education
• Oversaw reconciliation of 700+ accounts monthly, ensuring billing accuracy and compliance
• Directed quality assurance initiatives, internal audits, and customer satisfaction programs
• Produced executive-level daily, weekly, and monthly performance reports using Excel
• Ensured adherence to payer guidelines, regulatory standards, and internal policies

Prior Authorization Specialist - Community Surgical Supply

(2014-07 - 2016-11)

• Secured prior authorizations for DME and high-tech respiratory equipment
• Acted as liaison between payers, providers, and patients to resolve authorization issues
• Prepared denial letters and supported appeal processes
• Educated patients on coverage, eligibility, and affordability options

Diploma - Medical Billing & Coding - Chubb Institute