Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Tanicha Senatus

Summary

Motivated and results-driven professional with a B.S. in Management–Leadership and a minor in Accounting. I am currently advancing my education through an MBA program with a focus on Healthcare Administration. I am skilled in customer/member engagement and cross-functional collaboration, with expertise in CMS regulations, appeals/grievances, compliance, and quality improvement. Proven ability to facilitate member-focused initiatives, lead advisory discussions, and implement process improvements that enhance service delivery, member satisfaction, and compliance outcomes. Trilingual in English, Haitian Creole, and conversational French, with a strong commitment to advancing health equity, member experience, and organizational excellence. Highly skilled Appeals Coordinator with experience in managing complex appeals processes and coordinating cross-functional teams. Strengths include comprehensive knowledge of regulatory compliance, strong negotiation skills, and ability to maintain focus in high-pressure situations. Previous work has led to streamlined appeals procedures, improved client satisfaction, and enhanced team productivity.

Overview

6
6
years of professional experience
1
1
Certification

Work History

Administrative Manager

Fine Staffing Solutions
Methuen
12.2024 - Current
  • Oversee the daily operations and administrative staff to guarantee that projects and objectives are in accordance with the organization's strategy.
  • Formulate and execute policies and workflows to enhance compliance, optimize resource utilization, and streamline processes.
  • Cooperate with cross-departmental leaders to enhance the delivery of services and to facilitate executive decision-making.
  • Ensure that special projects are in accordance with the company's objectives and deadlines.
  • Ensure compliance and efficient resource utilization by managing budgets, monitoring expenses, and implementing policies.

Appeals and Grievances Specialist

Commonwealth Care Alliance
Boston
07.2020 - Current
  • Serve as a subject matter expert in CMS and state grievance/appeal regulations, ensuring compliance and supporting audit readiness.
  • Facilitate member engagement and outreach, addressing concerns with empathy and clarity to improve overall experience.
  • Collaborate with cross-functional teams-including quality, compliance, operations, and clinical services-to resolve cases and implement improvements.
  • Contribute to process improvement and complaint trend analysis, aligning recommendations with quality, satisfaction (CAHPS/HOS), and STAR rating goals.
  • Support team development by mentoring colleagues on regulatory requirements and best practices in case management.
  • Lead and resolve 100+ appeals monthly, ensuring 100% compliance with CMS and state regulatory deadlines.

Account Manager

TimePayment
Burlington
12.2019 - 06.2020
  • Managed customer relationships, resolving disputes, and inquiries to improve client satisfaction and retention.
  • Coordinated account activities, maintained accurate records, and ensured compliance with organizational policies.
  • Investigated and reconciled account discrepancies while ensuring compliance with policies and regulations.
  • Maintained accurate financial records, processed payments, and supported timely invoicing.
  • Strengthened client relationships through consistent communication and issue resolution.

Education

MBA - Health Administration

Southern New Hampshire University
Hooksett, NH
02-2027

Bachelor of Science - Management-Leadership, Accounting

University of Massachusetts Dartmouth
Dartmouth, MA

Skills

  • Process improvement
  • Customer service
  • Team collaboration
  • Staff management
  • Strategic planning
  • Administrative support
  • Organization and multitasking
  • Project management
  • Regulatory compliance
  • Conflict resolution
  • Quality assurance
  • Client relations

Certification

• Foundations of Project Management, Google
• Project Management Skills Certified Professional, Fitchburg State University

Timeline

Administrative Manager

Fine Staffing Solutions
12.2024 - Current

Appeals and Grievances Specialist

Commonwealth Care Alliance
07.2020 - Current

Account Manager

TimePayment
12.2019 - 06.2020

MBA - Health Administration

Southern New Hampshire University

Bachelor of Science - Management-Leadership, Accounting

University of Massachusetts Dartmouth
Tanicha Senatus