Kimyatta Tatum
Opa-locka,FL
Summary
Results-driven Licensed Health Insurance Agent with a proven track record at CVS, known for expertise in policy comparison and exceptional client relationship building. Demonstrated success in enhancing customer satisfaction through compliance with HIPAA regulations and streamlined enrollment processes. Highly skilled in claims processing and effective inbound call management, contributing to overall operational efficiency. Career goals include leveraging industry knowledge to further improve client outcomes and service delivery.
Overview
14
14
years of professional experience
Work History
Licensed Health Insurance Agent
CVS
Plantation, FL
11.2020 - 12.2024
- Analyze client information to recommend suitable policies that align with their health needs.
- Engage with clients to assess their insurance needs, and provide appropriate coverage options.
- Assist customers in enrolling in health insurance plans and help them understand their benefits.
- Use CRM tools to track client interactions, follow up on leads, and close sales.
- Build rapport and trust with clients while handling sensitive personal information.
- Stay updated on industry trends, regulations, and product offerings to better serve clients and comply with all state and federal regulations, including HIPAA.
- Collaborate with team members to achieve sales targets and enhance overall performance.
Case Manager/Customer Service Representative
Global Response
06.2015 - 05.2020
- Answer 40-80 calls per day on any questions inquiring about policy and procedures
- Create cases for exceptions to policy and the procedures
- Make outbound calls to provide resolution to case
- Search and locate to see item(s) are available in stores and place them on hold for the customers
- Document and investigate every store complaint and escalate them to the corresponding department
Claims Specialist
Choice Home Warranty
04.2014 - 12.2016
- Use CRM tools to track client interactions, follow up on leads, and close sales.
- Investigate, troubleshoot, and resolve verbal and written customer concerns across multiple channels.
- Produce a timely, clear and concise adjusting report with findings and recommendation for claim settlement within deadlines.
- Reviews and analyzes denials to determine best course of action based on the denial and remark codes.
- Review pictures and documents and approve/deny claims based on customers contracts.
- Ability to work independently while continuing to focus on goals and meeting deadlines.
- Strong ability to network, ask for referrals and build excellent relationships quickly.
Pharmacy Tech Assistant/Customer Service Representative (Contract)
Commcare Specialty Pharmacy
07.2014 - 06.2015
- Helps health care providers and patients by greeting them in person and by phone; answering questions and requests; referring inquiries to the pharmacist
- Protects patients and employees by adhering to infection-control policies and protocols
- Ensures medication availability by delivering medications to patients and departments
- Contributes to team effort by accomplishing related results as needed
Client Service Representative (Contract)
Cross Country Home Services
06.2014 - 07.2014
- Make outbound communications to the customer, client, and/or service provider informing them of claim status and/or offering assistance through the claim process to ensure exceptional customer care
- Provide back-up to the Receptionist/Switchboard Operator
- Review of claim credits invoices and supporting documentation for accuracy, validity, as well as verification of proof of payment
Data Entry/Customer Service Representative (Contract)
Quest Diagnostic
03.2014 - 04.2014
- Answer a high volume of calls from patients or their representative, regarding patient bill balances, payment plans, credit card payments, patient pricing, rebilling insurance companies and general customer concerns
- Maintain all Compliance and HIPAA regulations at all times
- Ability to work in a fast-paced environment
- Ability to meet quality standards
- Able to meet production standards
- Ability to handle other projects as assigned
- Prepare, deliver, receive, review and process enrollment application(s), including credentialing
- Update and complete the CRM dashboard daily with your activity
- Daily / Weekly / Monthly check-ins (via calls) and support for open needs
Customer Service Representative (Contract)
Caremark
11.2013 - 02.2014
- Answer 100-120 inbound calls from members inquiring about their prescriptions
- Order/cancel prescriptions for the members
- Authorize preauthorization from doctors for the members
Certified Nursing Assistant
Signature Healthcare
05.2011 - 12.2013
- Record patient information in manual and computerized logs
- Assist patients with ADL and answer patient calls and respond to emergencies
- Administer enema, douches and dressings as directed
- Turn and position patients as required
Education
High School Diploma -
Miami Carol City Senior High School
01.2007
Licensed Health Agent Certificate -
Skills
- Insurance terminology
- Policy comparison
- Compliance
- Enrollment processing
- Prospect relationship development
- Inbound call management
- Medicare expertise
- Claims processing
- Individual health plans
- Needs assessment
- HIPAA
- Policy analysis
Timeline
Licensed Health Insurance Agent
CVS
11.2020 - 12.2024
Case Manager/Customer Service Representative
Global Response
06.2015 - 05.2020
Pharmacy Tech Assistant/Customer Service Representative (Contract)
Commcare Specialty Pharmacy
07.2014 - 06.2015
Client Service Representative (Contract)
Cross Country Home Services
06.2014 - 07.2014
Claims Specialist
Choice Home Warranty
04.2014 - 12.2016
Data Entry/Customer Service Representative (Contract)
Quest Diagnostic
03.2014 - 04.2014
Customer Service Representative (Contract)
Caremark
11.2013 - 02.2014
Certified Nursing Assistant
Signature Healthcare
05.2011 - 12.2013
High School Diploma -
Miami Carol City Senior High School
Licensed Health Agent Certificate -
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