Tamara Tosen
Orlando,FL
Summary
Customer Service Representative bringing top-notch skills in oral and written communication, active listening and analytical problem-solving skills. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires, ad providing customized solutions to build loyalty.
Overview
9
9
years of professional experience
Work History
Prior Authorization Specialist
Careviso
01.2019 - 07.2023
- Input all patient data regarding claims and prior authorizations into system accurately.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Verified eligibility and compliance with authorization requirements for service providers.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
Dental Claims Specalist
VaxCare
12.2017 - 01.2019
- Generated, posted and attached information to claim files.
- Checked documentation for accuracy and validity on updated systems.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
- Maintained confidentiality of patient finances, records, and health statuses.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Verified client information by analyzing existing evidence on file.
Customer Service Representative
CVS Specialty Pharmacy
02.2014 - 12.2017
- Handled customer inquiries and suggestions courteously and professionally.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Answered constant flow of customer calls with minimal wait times.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Updated account information to maintain customer records.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
Education
High School Diploma -
Maynard Evans High School
Orlando, FL05.2006
Skills
- Health Insurance Plan Knowledge
- Status Updates
- Effective communication skills
Timeline
Prior Authorization Specialist
Careviso
01.2019 - 07.2023
Dental Claims Specalist
VaxCare
12.2017 - 01.2019
Customer Service Representative
CVS Specialty Pharmacy
02.2014 - 12.2017
High School Diploma -
Maynard Evans High School
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