Summary
Overview
Work History
Education
Skills
Interests
Timeline
Generic

Dejanae Tarver

Killeen,TX

Summary

Driven and detail-oriented Customer Service and Claims Specialist with extensive experience in delivering outstanding service, resolving complex issues, and ensuring compliance with industry regulations. Skilled in claims processing, customer relationship management, and data analysis, with a proven track record of streamlining workflows and enhancing customer satisfaction. Passionate about fostering a collaborative work environment and aspiring to advance into leadership roles where team management and strategic decision-making can drive organizational success. Proficient in utilizing advanced software platforms, including EMRs and Microsoft Office Suite.

Overview

6
6
years of professional experience

Work History

CSR

Tricare West
03.2025 - Current
  • Utilized claims management software to track and resolve issues efficiently.
  • Documented interactions and decisions in compliance with company standards.
  • Handled customer inquiries regarding insurance policy coverage details and payment status updates.
  • Managed electronic records using authorization management systems efficiently.
  • Resolved discrepancies in authorization requests through detailed investigation and communication.

CSR

WPS Health Solutions,Tricare For Life
02.2024 - 03.2025
  • Processed and adjudicated insurance claims with precision and compliance
  • Handled high volumes of customer inquiries and provided prompt resolutions
  • Communicated effectively with policyholders, healthcare providers, and stakeholders to address discrepancies
  • Maintained detailed records of interactions and ensured alignment with company and regulatory standards
  • Applied expertise in Medicare primacy, third-party liability, and COB for accurate claims review
  • Upsold products and services aligned with customer needs and company objectives

Enrollment Specialist

Orb Health, Inc.
07.2022 - 11.2023
  • Guided prospective patients through Medicare enrollment processes with clarity and efficiency
  • Collected and analyzed candidate data, ensuring accuracy in documentation and eligibility assessments
  • Processed enrollments and dis-enrollments utilizing Epic, Nextgen, and Athena EMR systems
  • Delivered personalized recommendations to improve patient understanding of program benefits

Customer Service Representative

Orb Health, Inc.
04.2022 - 06.2022
  • Scheduled medical and dental appointments with a professional and empathetic approach
  • Managed inbound and outbound calls, ensuring accurate customer account information
  • Delivered exemplary support in a fast-paced, customer-focused environment

Customer Service Representative

Call Management Resources
11.2021 - 03.2022
  • Company Overview: Remote
  • Provided professional answering services for diverse client needs, ensuring accurate call handling
  • Assisted with appointment scheduling, message forwarding, and follow-ups
  • Addressed and escalated customer inquiries as needed to meet service excellence standards
  • Maintained client confidentiality and adhered to strict communication protocols

Customer Service Representative

AnywhereWorks
Killeen, USA
10.2020 - 10.2021
  • Company Overview: Killeen, TX
  • Delivered tailored answering services across various channels, including live chat and phone
  • Scheduled and managed appointments, ensuring seamless communication for clients
  • Fostered strong relationships through professional and courteous interactions
  • Streamlined processes to improve efficiency in call-handling and client satisfaction
  • Killeen, TX

Customer Service Representative

GC Services Limited Partnership
Copperas Cove, USA
08.2019 - 09.2020
  • Evaluated customer accounts to identify trends and provide targeted solutions
  • Resolved billing inquiries, processed payments, and offered setup assistance for payment options
  • Documented customer interactions for comprehensive tracking and effective resolution
  • Copperas Cove, TX

Education

Associate of Applied Science - Video Game Art

Austin Community College
Austin, TX

Associate of Arts -

Central Texas College
Killeen, TX

Skills

  • Customer Relationship Management (CRM)
  • Claims Processing & Adjudication
  • Conflict Resolution & Problem Solving
  • Data Entry & Analysis
  • Multitasking & Time Management
  • Strong Interpersonal & Communication Skills
  • Regulatory Compliance & Documentation
  • Technical Proficiency: EMRs (Epic, Nextgen, Athena), Microsoft Office Suite, Google Workspace
  • Call Center Operations & High-Volume Call Handling
  • Team Collaboration & Leadership
  • Sales & Upselling Techniques
  • Medical Terminology & Managed Care Knowledge
  • Scheduling & Coordination
  • HIPAA Compliance
  • Customer Retention Strategies
  • Performance Metrics & Reporting
  • Typing Speed: 60 WPM
  • Proficient in SharePoint, WordPress, MacOS, and iOS
  • Experienced in technical troubleshooting and help desk operations
  • Knowledgeable in financial services and fact-checking protocols
  • Collaborative and adaptable team player with strong organizational skills

Interests

Physics, Space, Reading, Collecting, Puzzles, Psychology

Timeline

CSR

Tricare West
03.2025 - Current

CSR

WPS Health Solutions,Tricare For Life
02.2024 - 03.2025

Enrollment Specialist

Orb Health, Inc.
07.2022 - 11.2023

Customer Service Representative

Orb Health, Inc.
04.2022 - 06.2022

Customer Service Representative

Call Management Resources
11.2021 - 03.2022

Customer Service Representative

AnywhereWorks
10.2020 - 10.2021

Customer Service Representative

GC Services Limited Partnership
08.2019 - 09.2020

Associate of Applied Science - Video Game Art

Austin Community College

Associate of Arts -

Central Texas College

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