Nijah Tyler
Bellevue,NE
Summary
Motivated and results-oriented professional seeking to contribute to a dynamic and impactful organization. Bringing strong problem-solving abilities and a collaborative mindset, I am eager to excel in a fast-paced environment while promoting teamwork and a positive work culture, all in pursuit of advancing my career with an outstanding company.
Overview
7
7
years of professional experience
Work History
Member Service Representative
Genesis10 (Contract)
Omaha, NE
05.2022 - 05.2023
- Provided comprehensive support to members, addressing inquiries, troubleshooting issues, and ensuring high-level customer satisfaction.
- Successfully tackled intricate issues related to fraud and abuse concerns through proactive investigation, solution identification, and the effective utilization of available resources.
- Collaborated with cross-functional teams to streamline processes, leading to enhanced efficiency and a seamless member experience.
- Demonstrated strong interpersonal skills in written and verbal communication, delivering clear and concise responses to members.
- Actively contributed to the improvement of internal knowledge bases by suggesting updates and sharing insights from member interactions.
- Participated in ongoing training sessions to stay updated on the latest company products, services, policies, and industry trends.
Producer Services
Remedy Intelligent Staffing (Contract)
Omaha, NE
03.2022 - 05.2022
- Evaluated brokerage life and health contract packets, ensuring compliance with policy and state requirements.
- Coordinated information gathering for agent and corporation onboarding, managing outstanding tasks.
- Collaborated with agents, marketers, and internal partners to ensure contract documents are accurate.
- Conducted debit balance and background checks for potential re-contract agents.
- Input updates, such as name changes and direct deposit information, based on state requirements.
- Offered feedback during team huddles to enhance tools, workflows, and procedures.
Trust & Safety Content Analyst
Swoon Group (Contract)
Omaha, NE
11.2020 - 11.2021
- Enforced content policies, resolved spam, account takeover, and terms of service violations.
- Stayed current on workflow changes, operational guidelines, and policy updates.
- Conducted research using appropriate tools, identifying problems, and communicating with internal partners.
- Provided feedback to leads on necessary changes, including policies and technical issues.
Clinical Review Technician
Prime Therapeutics LLC
Omaha, NE
09.2019 - 07.2020
- Reviewed drug authorization history to prevent fraud and abuse. Processed requests for formulary exceptions.
- Managed data input, documentation, and communication for utilization management requests.
- Delivered clinical information to Clinical Review Pharmacist and physicians.
- Interacted with pharmacies and physicians, ensuring accurate claims adjudication.
Insurance Resolution Representative
EMS Billing Services Inc.
Omaha, NE
11.2017 - 09.2019
- Managed insurance aging reports, rectified errors on claims, and handled appeals.
- Communicated with law offices, collection agencies, and insurance companies.
- Processed claims and appeals, answering complex patient inquiries.
- Maintained professionalism in communication via phone, email, and fax.
Underwriter
Remedy Intelligent Staffing (Contract)
Omaha, NE
04.2017 - 11.2017
- Managed insurance aging reports, rectified errors on claims, and handled appeals.
- Communicated with law offices, collection agencies, and insurance companies.
- Processed claims and appeals, answering complex patient inquiries.
- Maintained professionalism in communication via phone, email, and fax.
Customer Solutions Teammate
PayPal Inc
Omaha, NE
04.2016 - 03.2017
- Monitored customer transactions to detect instances of high-risk and fraudulent activities, minimizing potential revenue losses.
- Managed the processing of Reg E and non-Reg E disputes for PayPal debit cardholders, ensuring timely resolution.
- Delivered exceptional customer service to both new and long-standing clients, actively addressing concerns, and devising effective solutions.
- Responded promptly to a range of inquiries from internal and external stakeholders within PayPal's Debit Card division, while also offering support for general inquiries about other PayPal products.
- Gathered and processed sensitive information for application submissions, meticulously determining eligibility for the Debit Card program.
Education
*
Skills
- Internet & Social Media: Comprehensive understanding of platforms and content moderation
- Project Management: Proven track record in managing projects to enhance efficiency
- Communication: Effective written and verbal communication; strong interpersonal skills for client relations and conflict resolution
- Critical Thinking: Adaptable with strong analytical skills for problem-solving
- Typing Proficiency: 48 WPM with data entry and 10-key expertise
- Client Services: Skilled in building and maintaining client relationships
- Administrative Functions: Proficient in managing tasks to streamline operations
- Team Leadership: Experienced in leading and motivating teams for collaboration and goal achievement
- Process Improvement: Identifying and implementing enhancements for productivity
- Attention to Detail: Ensures accuracy in all tasks and projects
- Research Skills: Capable of gathering and synthesizing information effectively
- Compliance: Knowledgeable in PII, HIPAA, and OSHA regulations
- Fraud Prevention: Familiar with strategies to prevent fraudulent activities
- Safety & Security: Understanding of safety protocols to maintain a secure workplace
Timeline
Member Service Representative
Genesis10 (Contract)
05.2022 - 05.2023
Producer Services
Remedy Intelligent Staffing (Contract)
03.2022 - 05.2022
Trust & Safety Content Analyst
Swoon Group (Contract)
11.2020 - 11.2021
Clinical Review Technician
Prime Therapeutics LLC
09.2019 - 07.2020
Insurance Resolution Representative
EMS Billing Services Inc.
11.2017 - 09.2019
Underwriter
Remedy Intelligent Staffing (Contract)
04.2017 - 11.2017
Customer Solutions Teammate
PayPal Inc
04.2016 - 03.2017
*