TAJAH ANDERSON
Jacksonville,FL
Summary
Dynamic and dedicated professional with an Associate of Arts degree and ongoing pursuit of a Bachelor's degree. Experienced in providing exceptional customer service and adept in health insurance policies and procedures. Seeking a challenging role in customer service within the health insurance industry to leverage skills and contribute to organizational success.
Overview
5
5
years of professional experience
1
1
Certification
Work History
Member Service Representative
Alignment Health Plan
Jacksonville, FL
08.2023 - Current
- Understand procedures, protocols, benefits, services, and any other necessary information to resolve member issues and inquiries; serve as a “subject matter expert” in the healthcare experience that our members navigate daily
- Be a representative that provides outbound and inbound support via the phone at a fast pace.
- Manage to the member’s communication preferences as possible, which may include time of day, channel, and language; utilize interpreter service as needed
- Collaborate with our partners – including but not limited to other departments, supplemental benefit vendors, and provider network – to facilitate the member experience.
- Excel in customer service and contribute to a culture of going “above and beyond” to ensure the highest level of member satisfaction.
Patient Care Coordinator
EveriseC3Connects
Jacksonville
12.2022 - 08.2023
- Scheduled patient visits and answered questions, including billing and preparation
- Ensured services comply with state and federal regulatory requirements
- Determined a patient's eligibility for different community support and financial assistance programs, enabling them to access the care they need
- Assisted patients who may not be able to manage their care on their own, such as disabled or elderly people
- Used data to do analytical tasks and charting tasks related to patient information
- Communicated with patients about their status and condition through emails, phone conversations
- Managed patient accounts with contact information, insurance, and financial information in a confidential manner.
Everise C3CONNECTCHANNELS (ALIGHT) - Licensed Health Insurance Agent
Jacksonville
07.2022 - 12.2022
- Sold health insurance or other types of insurance to consumers, customizing programs to cover a variety of risks to meet the needs of every individual
- Met with clients daily to provide them with information about how to handle a policy claim, how to update policies, and how to maintain appropriate records for possible claims
- Attended programs, seminars, and meetings to learn about new services and products, receive technical assistance, and learn new marketing and selling skills
- Created marketing strategies that bring customers to your insurance agency rather than another
- Guaranteed that all necessary paperwork is filled out and filed to put the insurance policy in place
- Communicated with customers and underwriters to determine which types of insurance are offered and which are most applicable to the specific customer
- Monitored any claims made to guarantee that both the insurer and the client are compensated fairly
- Sought new clients through calling lists of prospective clients on a daily basis.
Everise C3CONNECTCHANNELS (OPTUMRX)
Jacksonville
02.2022 - 07.2022
- Evaluated insurance claims for accuracy and the coverage amount
- Obtained additional information about a customer to determine coverage needs
- Investigated, evaluated, and settled insurance claims
- Determined whether the insured's policy covers the claimed loss
- Ensured that claims are not fraudulent
- Contacted claimant's employers or doctors for additional information if the claim is questionable
- Took customer calls and provided accurate, satisfactory answers to their queries and concerns
- De-escalated situations involving dissatisfied customers, offering patient assistance and support
- Called clients and customers to inform them about the company's new products, services, and policies
- Guided callers through troubleshooting, navigating the company site, or using the products or services.
Everise C3CONNECTCHANNELS (Humana) - Customer Service Representative
Jacksonville
08.2021 - 02.2022
- Performed general office duties, including answering multi-line phone system, routing calls, delivering messages to staff and greeting visitors
- Acted as first point of contact and set appointments for prospective clients
- Handled client correspondence and tracked records to foster office efficiency
- Scanned documents and saved in database to keep records of essential organizational information
- Inspected floor displays, noted missing items and immediately replenished merchandise
- Utilized culinary and cutlery tools to prepare various foods for cooking or cold dish presentations
- Organized, arranged, and restocked various stations, including buffet, salad bar, and service areas
- Maintained clean, trash-free workspaces to maximize productivity and safety
- Maintained composure and work quality while under stress
- Monitored dining room and guest flow to maximize table usage and minimize wait times
- Documented reservations and communicated changes to guests.
Potter's House Soul Food Bistro - Hostess/Line Worker
Jacksonville
01.2020 - 08.2021
- Monitored dining room and guest flow to maximize table usage and minimize wait times
- Documented reservations and communicated changes to guests
- Promoted the insurance agency to customers who need insurance
- Networked with potential customers
- Educated customers on each type of insurance coverage and made recommendations based on their needs
- Evaluated current insurance policies and recommended additional coverage when needed
- Maintained all insurance documents in a confidential way.
City Of Jacksonville Military/ Veteran's Affair Administrative Assistant
Jacksonville
01.2020 - 07.2020
- Acted as first point of contact and set appointments for prospective clients
- Performed general office duties, including answering multi-line phone system, routing calls, delivering messages to staff and greeting visitors
- Handled client correspondence and tracked records to foster office efficiency
- Scanned documents and saved in database to keep records of essential organizational information.
Potter's House Soul Food Bistro - Hostess/Line Worker
Jacksonville
08.2019 - 11.2019
- Inspected floor displays, noted missing items and immediately replenished merchandise
- Utilized culinary and cutlery tools to prepare various foods for cooking or cold dish presentations
- Organized, arranged, and re-stocked various stations, including buffet, salad bar, and service areas
- Maintained clean, trash-free workspaces to maximize productivity and safety
- Maintained composure and work quality while under stress.
Education
High School Diploma -
Andrew Jackson High School
05.2020
Bachelor of Arts -
University of South Florida
Skills
- Process optimization
- Faxing Paperwork
- MS Office Suite Knowledge
- Dining area cleanliness
- Multi-line phone talent
- Office administration
- Document Conversion
- Communication skills
- Inbound and Outbound Calling
- Good listening skills
- Issue Resolution
- Member Retention
- Service Upselling
- Membership Renewals
- Healthcare Knowledge
- Complaint Handling
- Sales Strategy
- Policy Understanding
- Customer Service
- Insurance Knowledge
Certification
- Licensed Health Insurance Agent
Timeline
Member Service Representative
Alignment Health Plan
08.2023 - Current
Patient Care Coordinator
EveriseC3Connects
12.2022 - 08.2023
Everise C3CONNECTCHANNELS (ALIGHT) - Licensed Health Insurance Agent
07.2022 - 12.2022
Everise C3CONNECTCHANNELS (OPTUMRX)
02.2022 - 07.2022
Everise C3CONNECTCHANNELS (Humana) - Customer Service Representative
08.2021 - 02.2022
Potter's House Soul Food Bistro - Hostess/Line Worker
01.2020 - 08.2021
City Of Jacksonville Military/ Veteran's Affair Administrative Assistant
01.2020 - 07.2020
Potter's House Soul Food Bistro - Hostess/Line Worker
08.2019 - 11.2019
High School Diploma -
Andrew Jackson High School
Bachelor of Arts -
University of South Florida
- Licensed Health Insurance Agent
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