TaffaTee Johnson
Summary
Detail-oriented healthcare operations professional with experience analyzing claims, identifying discrepancies, and supporting data-driven decision-making in fast-paced environments. Skilled in problem-solving, cross-functional collaboration, and ensuring compliance with policies and procedures. Proven ability to evaluate information, identify trends, and support business outcomes through accurate data review and process improvement. Strong communicator with a focus on quality, efficiency, and continuous learning.
Overview
21
21
years of professional experience
1
1
Certification
Work History
Customer Service Representative II
Kaiser Permanente
Georgia, US
05.2024 - Current
- Analyze healthcare claims and member cases to identify discrepancies, errors, and potential fraud.
- Review and interpret member benefits, policies, and guidelines to ensure compliance with organizational standards
- Investigate complex inquiries by gathering and evaluating data across multiple systems
- Identify trends and recurring issues within member cases to support process improvement and operational efficiency
- Collaborate with internal teams to resolve escalations and improve workflow efficiency
- Provide accurate, timely, and consistent information to members, providers, and stakeholders
- Utilize critical thinking to assess issues, identify root causes, and recommend solutions
- Maintain detailed documentation to support case resolution, compliance, and audit readiness
- Identify trends and reoccurring issues within member cases and support process improvement and optional efficiency
Senior Customer Service Professional
Verizon Wireless
Alpharetta, GA
07.2014 - 10.2023
- Oversaw resolution of escalated customer cases through detailed analysis and effective problem-solving.
- Utilized CRM systems to monitor, analyze, and document customer interactions and trends.
- Delivered technical support and service solutions by assessing customer needs and analyzing system data.
- Cultivated comprehensive understanding of products, services, and pricing structures.
- Improved customer experience by identifying issues and implementing tailored solutions
- Educated customers on tools and resources to promote efficiency and self-service usage
According Auditor/Customer Service Manager
Burlington Coat Factory
Marietta, GA
06.2012 - 07.2014
- Evaluated financial data and records to guarantee accuracy, compliance, and operational efficiency.
- Analyzed financial documentation to identify discrepancies and implemented corrective actions.
- Conducted risk assessments to detect potential fraud or non-compliance
- Prepared reports outlining findings and supporting business decision-making
- Supervised and coached team members to ensure high-quality service and operational efficiency
- Identified process improvement opportunities and implemented solutions to enhance performance
- Resolved customer issues and escalations while maintaining compliance with company policies
- Led team meetings to communicate updates, expectations, and performance goals
Human Resources Specialist
The GEO Group, Inc.
South Bay, FL
01.2005 - 06.2012
- Developed and implemented employee onboarding programs to enhance retention and engagement.
- Managed recruitment processes, ensuring alignment with organizational goals and diversity initiatives.
- Conducted training sessions on compliance, policies, and best practices for staff development.
- Collaborated with management to design performance appraisal systems that align with strategic objectives.
- Mentored junior HR staff, enhancing team capabilities and promoting professional growth within the department.
- Streamlined HR processes by integrating technology solutions for payroll and benefits administration.
- Led conflict resolution efforts, fostering a positive work environment through effective communication strategies.
- Maintained personnel records and statistical data to establish accuracy and compliance with applicable regulations.
Education
Associate of Arts - Project Management
Coursera
2024
Associate of Arts - Computer And Information Sciences
Coursera
2023
Bachelor of Arts - Business Administration And Management
Capella University
2019
Skills
- Data Analysis & Interpretation
- Claims Review & Discrepancy Identification
- Compliance & Policy Adherence
- Critical Thinking & Problem Solving
- Cross-Functional Collaboration
- Process Improvement
- Customer & Member Support
- CRM & Microsoft Office Suite
- Escalation Management
- Documentation & Reporting
Certification
- Business Analysis & Management
- Investment Risk Management
- Introduction to Microsoft Excel
- Jira Fundamentals
Timeline
Customer Service Representative II
Kaiser Permanente
05.2024 - Current
Senior Customer Service Professional
Verizon Wireless
07.2014 - 10.2023
According Auditor/Customer Service Manager
Burlington Coat Factory
06.2012 - 07.2014
Human Resources Specialist
The GEO Group, Inc.
01.2005 - 06.2012
Associate of Arts - Project Management
Coursera
Associate of Arts - Computer And Information Sciences
Coursera
Bachelor of Arts - Business Administration And Management
Capella University