Summary
Overview
Work History
Education
Skills
Timeline
Generic

TANESHA CLEVELAND

Greenfield,WI

Summary

Focused customer service professional dedicated to meeting and exceeding customer expectations by delivering industry-leading support. Skilled in handling inbound and outbound calls, online requests and emails with good problem-solving, multitasking and research abilities. Background in Insurance and medical roles with high-volume customer demands.

Overview

9
9
years of professional experience

Work History

Customer Care Representative

Ascension
Troy, MI
11.2021 - Current
  • Provide incoming calls for authorization status.
  • Assisted claimants, providers, and clients with problems or questions regarding claims.
  • Documented specific claims by completing and recording forms, reports and logs.
  • Navigated the computer system to look up customer information and update policies.
  • Coordinated and planned investigations of claims to confirm compensability and coverage.
  • Complete insurance verification on intakes.
  • Request and follow up appropriately for authorizations.

Customer Care Representative

Anthem
05.2019 - 01.2021
  • Checked to ensure that appropriate changes were made to resolve customers' problems
  • Contacted customers to respond to inquiries or to notify them of claim investigation results or any planned adjustments
  • Kept records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken
  • Referred unresolved customer grievances to designated departments for further investigation
  • Resolved customers' service or billing complaints by performing activities such as exchanging merchandise, refunding money, or adjusting bills

Customer Service Representative

Delta Dental
10.2018 - 02.2019
  • Conferred with customers by telephone or in person to provide information about products or services, take or enter orders, cancel accounts, or obtain details of complaints
  • Contacted customers to respond to inquiries or to notify them of claim investigation results or any planned adjustments
  • Kept records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken
  • Referred unresolved customer grievances to designated departments for further investigation
  • Resolved customers' service or billing complaints by performing activities such as exchanging merchandise, refunding money, or adjusting bills
  • Solicited sales of new or additional services or products

Preauthorization Specialist

Molina Healthcare
Milwaukee, WI
07.2016 - 03.2018
  • Complete Insurance verification on all new intake
  • Request and follow up appropriately for authorization
  • Complete Payor change forms and insurance verification
  • Coordinate intakes to offices notification of referrals
  • Perform other duties assigned

Education

Associate of Science Degree - Medical Billing and Coding

Ultimate Medical Academy
2022

Skills

  • Customer Service
  • Teamwork and Collaboration
  • High-Energy Attitude
  • Product and Service Knowledge
  • Remote Office Availability
  • Insurance Claims Review
  • Policy Understanding
  • Data Entry
  • Patient Scheduling
  • Effective Communication Skills
  • Understanding of Medical Terms
  • Medical Coding
  • Insurance Procedures
  • Medical Terminology
  • Insurance verification

Timeline

Customer Care Representative

Ascension
11.2021 - Current

Customer Care Representative

Anthem
05.2019 - 01.2021

Customer Service Representative

Delta Dental
10.2018 - 02.2019

Preauthorization Specialist

Molina Healthcare
07.2016 - 03.2018

Associate of Science Degree - Medical Billing and Coding

Ultimate Medical Academy

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