Tammy Bridges
Mabank,TX
Summary
Detailed-oriented and analytical Claims Analyst in research and resolving claim errors, discrepancies, and processing issues, processing and adjusting claims in alignment with company workflow while ensuring accuracy, compliance, and timely resolution. Proficient in claims management systems including Amysis, Cenpas, True Care Cloud, and Filenet, with a strong track record of maintaining productivity benchmarks in high-volume environments. Adept at delivering exceptional customer service, addressing inquiries with professionalism, and ensuring data integrity through meticulous review and verification.
Overview
27
27
years of professional experience
Work History
Provider Escalations Advocate
Centene Corp.
02.2024 - Current
- Conduct detailed research on claims to identify errors, discrepancies, and processing issues
- Process and adjust claims in accordance with company workflow
- Utilize systems such as Amysis, Cenpas, True Care Cloud, and Filenet for claims review and documentation
- Data review & accuracy verification
- Provide excellent customer service when handling inquiries related to claims status and adjustments
- Maintain 100% accuracy and meet productivity benchmarks in high volume environments
Customer Service Representative
Fulton Bank
02.2023 - 02.2024
- Engaged in problem-solving to resolve customer issues and enhance satisfaction.
- Assisted customers with inquiries and concerns.
- Utilized multiple systems to streamline customer interactions and improve service delivery.
- Assisted members with banking needs, ensuring accurate and timely transactions.
- Resolve provider issues.
- Resolved customer inquiries through effective communication and problem-solving strategies.
- Processed transactions accurately using banking software and tools.
- Managed customer accounts, ensuring data integrity and compliance with bank policies.
Assistant Manager/Server/Bartender
Fredonia Hotel
10.2019 - 06.2022
- Support the Manager in overseeing daily restaurant operations
- Supervised and coordinate front-of-house
- Training, coaching, and mentoring new and existing employees
- Handle customer complaints and resolve issues quickly to maintain satisfaction
- Create training schedule
- Ensure compliance with health and safety regulations
- Assist with cash handling, deposits, and daily sales reporting
- Assisted with managing 30 team members
- Supervised daily operations to ensure optimal guest experience and service quality.
- Trained and mentored staff on hotel policies, enhancing team performance and efficiency.
- Coordinated cross-departmental communication to streamline processes and improve collaboration.
- Implemented training programs that increased employee engagement and service delivery standards.
General Manager
Tammy's Hide-Away
10.1999 - 03.2014
- Owner/Operator overseeing daily bar operations
- Management 10 plus team members
- Developed high-performance team through targeted recruitment and training.
- Collaborated on changing initiatives to align organizational goals with operational strategies.
- Evaluated team performance and recommended promotions to enhance talent within organization.
- Built policy and procedures.
- Training, coaching, and mentor new and existing employees
- Implemented loss prevention strategies to minimize theft
- Cash handling, deposits, and daily sales reporting
- Prepared tax documents for CPA
Education
Bachelor of Business Administration - Tourism and Hospitality
Columbia Southern University
Orange Beach, AL08.2023
Skills
- Micro Soft Suite
- Document review
- Ability to be independent
- Multitasking
- Claims adjustment and processing
- Analytical and problem-solving skills
- Critical thinking
- Claims research
Accomplishments
Dean's List
Timeline
Provider Escalations Advocate
Centene Corp.
02.2024 - Current
Customer Service Representative
Fulton Bank
02.2023 - 02.2024
Assistant Manager/Server/Bartender
Fredonia Hotel
10.2019 - 06.2022
General Manager
Tammy's Hide-Away
10.1999 - 03.2014
Bachelor of Business Administration - Tourism and Hospitality
Columbia Southern University