Tiffany Wegworth
Grafton,WV
Summary
Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
14
14
years of professional experience
Work History
PROJECTS WITH CIGNA
Cigna
12.2023 - Current
- In December of 2023 I was tasked with assisting the escalations back office with catching up their workload
- I effectively and efficiently worked on schedule escalation call backs scheduled by front line representatives
- The escalations were member complaints regarding policies and claims
- My job was to review the entire claim from beginning to end to find where a problem occurred
- I would then reach out to escalated members to assist them
- I would often need to contact the claims advocate working on their claim or reach out to providers for medical records
- I would continue following up with the members until their claims were complete
- In the case of policies, it would be regarding ported policies and billing issues
- I would resolve the issue by contacting the member and the processing center to locate payments, updating policy paid to date and policy status
- As of 7/30/2024 the entire backlog of work has been cleared and I returned to the frontline.
- Resolved customer complaints promptly, maintaining high levels of customer satisfaction.
CLAIMS INTAKE
Cigna Supplemental Health Solutions
09.2023 - Current
- My duties include taking incoming calls for claim intake, claim status, portability information and payments, as well as Open enrollment policy questions
- Supplemental Benefits is a high volume of data entry requiring attention to detail and accuracy
- I use multiple screens to effectively and efficiently move through up to 15 different claimant and client information management systems
- I have 99.95 schedule adherence, high customer satisfaction scores and low client handle times
- I sign up for overtime when needed and perform my work with dignity and professionalism
- I work well in a team and on my own.
COMPLIANCE ASSOCIATE
Center One/Continental Finance Company
09.2022 - 01.2023
- Reviewing company complaints to determine severity and summarizing recorded calls.
- Maintained up-to-date knowledge of regulatory changes, informing management of any potential impacts on company operations.
- Collaborated with cross-functional teams to ensure timely resolution of compliance issues and promote adherence to industry standards.
- Reduced potential legal exposure by identifying areas of non-compliance and recommending corrective actions.
- Conducted thorough investigations into potential violations, ensuring appropriate documentation and follow-up measures were implemented.
- Assisted in maintaining a culture of ethical conduct by providing training on relevant laws, regulations, and company policies.
CREDIT REPORTING SPECIALIST
Center One/Continental Finance
06.2022 - 09.2022
- My duties are to review, evaluate and respond to a consumer dispute on their account reporting
- Disputes are received via E-Oscar, and I am responsible for responding via Sonnet
- This requires detailed investigations into the consumer account to ensure that our legal obligations and requirements are met
- This does sometimes entail updating payment history via Green Screen as well.
- Followed all company policies and procedures to deliver quality work.
- Improved customer satisfaction rates through proactive problem-solving and efficient complaint resolution.
- Coordinated with legal and compliance teams for smooth execution of credit-related agreements and documentation, ensuring adherence to all regulatory requirements.
- Resolved any conflicts or disputes between clients, staff, and vendors in a professional manner.
- Consistently met or exceeded departmental goals for both quality and quantity of processed credit applications.
- Played a crucial role in maintaining alignment with accreditation standards, ensuring that the facility met or surpassed all relevant benchmarks during inspections.
- Prepared detailed reports to present analysis of client creditworthiness using e-Oscar and Lexus Nexus.
CUSTOMER RELATIONS MANAGER
Center One/Continental Finance
01.2022 - 06.2022
- My role as a customer relations Manager is to assist customers in managing their accounts, offering work out programs to bring their account current and to communicate all customer concerns to the appropriate department
- To give each customer white glove customer service and create a mutually beneficial relationship
- This is a busy call center environment.
DIRECTOR OF SALES AND RENTALS
NewRay Realty
12.2018 - 03.2020
- Duties include customer service to new and prospective tenants
- On call to handle any tenant emergencies that may arise
- Showing prospective tenants available housing
- Work with tenants in a second chance rental environment to provide solutions to encourage timely rental and mortgage payments
- To ensure a mutually beneficial relationship between the company and tenants.
- Enhanced customer satisfaction levels by addressing concerns promptly and providing tailored solutions.
ADMINISTRATIVE ASSISTANT
Nevada Onion
11.2017 - 02.2018
- Clerical duties including shipping labels and orders, billing, multi-line phone systems and multiple office equipment
- Handling new employee safety orientation and monthly safety meetings for all employees.
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Maintained confidentiality of sensitive information by adhering to strict privacy policies and implementing secure filing systems.
- Ensured accurate record-keeping with diligent data entry and database management for vital company information.
PUBLIC WEIGHMASTER
NEVADA HAY GROWERS
09.2015 - 11.2017
- Key duties include weighing semi-trucks loaded with local agricultural products
- I was responsible for keeping track of inventory of NHGA hay and billing for all hay or cube product movements
- Responsible for keeping track of customer orders and billing using a program unique to this business
- Helping to prepare customer and grower billing statements for individual billing, monthly and yearly
- Answering phones and directing questions to the appropriate person if unable to answer them myself.
ADMINISTRATIVE ASSISTANT
YERINGTON CHAMBER OF COMMERCE
01.2011 - 01.2013
- Customer service for the Chamber of commerce
- Duties include welcoming tourists to our community, taking minutes for monthly board meetings, writing, and sending out quarterly newsletters, as well as organizing and helping put on community events such as the annual lighting of the Yerington Christmas tree and the Fair and Rodeo Parade.
Education
HIGH SCHOOL DIPLOMA - General Education
Bret Harte Union High School
Altaville, CA06.1995
Skills
- Friendly, Positive Attitude
- Teamwork and Collaboration
- Customer Service
- Problem-Solving
- Time Management
- Attention to Detail
- Dependable and Responsible
- Excellent Communication
- Critical Thinking
- Problem Resolution
- Decision-Making
- Organization and Time Management
Skillsabilities
Proficient in the use of Microsoft Word, Excel, and PowerPoint 2016., Knowledgeable in data management using Haymaker., Knowledgeable in filing systems., Data Entry., Competent in the use of computers, fax machines, phones, scales, and copy machines., Experience working with vendors, transportation companies, and growers., Courteous, and prompt customer service., De-escalation training and experience., Knowledge of advertising using promotional materials., Experience with funding grants for nonprofits., Proficient in Solution Builder., Proficient in CCA., Proficient in Green Screen., Proficient in Sonnet/E-Oscar., Familiar with FCRA, Graham Bliely Act, SCRA., Proficient in multiple CRM systems., Clear communication skills in both written and verbal methods., Understanding of email usage including drafting, sending, and archiving procedures., Very well versed in de-escalation and claim troubleshooting and resolving disputes., Silver State Livestock Show: Served as The Goat Superintendent in the first 2 years., 4H goat and livestock club leader in Yerington, NV.
References
- Mike McClusky, 716-603-4705
- Michelle Evasovic, 775-224-1448
- Allyson Swable, 940-882-1101
- Nancie Probst, 304-694-1012
- Patricia Netherton, 702-758-1428 evening only.
- Glennisha Brooks, 251-622-0197
Timeline
PROJECTS WITH CIGNA
Cigna
12.2023 - Current
CLAIMS INTAKE
Cigna Supplemental Health Solutions
09.2023 - Current
COMPLIANCE ASSOCIATE
Center One/Continental Finance Company
09.2022 - 01.2023
CREDIT REPORTING SPECIALIST
Center One/Continental Finance
06.2022 - 09.2022
CUSTOMER RELATIONS MANAGER
Center One/Continental Finance
01.2022 - 06.2022
DIRECTOR OF SALES AND RENTALS
NewRay Realty
12.2018 - 03.2020
ADMINISTRATIVE ASSISTANT
Nevada Onion
11.2017 - 02.2018
PUBLIC WEIGHMASTER
NEVADA HAY GROWERS
09.2015 - 11.2017
ADMINISTRATIVE ASSISTANT
YERINGTON CHAMBER OF COMMERCE
01.2011 - 01.2013
HIGH SCHOOL DIPLOMA - General Education
Bret Harte Union High School
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