Anshawon Tyler
Houston, TX
Summary
Dynamic Claims Specialist with proven expertise at Molina Healthcare, excelling in claims processing and customer service. Recognized for enhancing client satisfaction through effective communication and problem-solving skills. Successfully managed complex claims and built strong partnerships, ensuring timely resolutions and positive outcomes. Committed to maintaining high standards of professionalism in all interactions.
Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Overview
14
14
years of professional experience
Work History
Claims Specialist
Molina Healthcare
03.2022 - 02.2025
- Enhanced customer satisfaction with timely communication, empathy, and clear explanations of claim outcomes.
- Managed a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills.
- Developed strong working relationships with external partners such as adjusters, legal counsel, and medical professionals to facilitate efficient claim resolution processes.
- Settled complex claims fairly by applying critical thinking, negotiation skills, and detailed knowledge of insurance policies.
- Handled high-pressure situations with professionalism and composure, consistently achieving positive outcomes for both clients and the organization.
Customer Service Representative
Village Family Practice
06.2017 - 01.2022
- Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
- Enhanced patient satisfaction by efficiently addressing and resolving healthcare-related inquiries.
- Maintained accurate records of customer interactions, ensuring proper documentation within the company''s database.
- Facilitated smooth communication between patients, insurance companies, and medical staff for seamless coordination of care.
Junior Law Clerk
Perdue Brandon Fielder Collins & Mott
09.2010 - 03.2017
- Drafted clear and concise legal documents, leading to improved communication between parties involved.
- Assisted senior attorneys in preparing cases for trial, resulting in favorable outcomes for the clients.
- Managed multiple cases simultaneously, prioritizing tasks effectively to meet strict deadlines without compromising quality.
- Created and prepared legal drafts by organizing and assembling information for legal documents and forms.
- Analyzed case data to determine the most effective course of action while maintaining ethical standards throughout all stages of representation.
Education
Associate of Science - Business Management
Houston Community College
Houston, TX08-2009
High School Diploma -
Westbury High School
Houston, TX05-2006
Skills
- Claims processing
- Verbal communication
- Payments posting
- Teamwork
- Customer service
- Time management
- Problem-solving abilities
- Call center operations
Timeline
Claims Specialist
Molina Healthcare
03.2022 - 02.2025
Customer Service Representative
Village Family Practice
06.2017 - 01.2022
Junior Law Clerk
Perdue Brandon Fielder Collins & Mott
09.2010 - 03.2017
Associate of Science - Business Management
Houston Community College
High School Diploma -
Westbury High School
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