Tanisha Douglas
Southfield,MI
Summary
Professional assistant with experience in administrative support and operational efficiency. Strong focus on team collaboration and achieving results. Reliable in adapting to changing needs, skilled in communication, organization, and multitasking. Recognized for problem-solving abilities and proactive approach to tasks.
Overview
10
10
years of professional experience
Work History
Health and Wellness Engagement Assistant
Blue Cross and Blue Shield
12.2023 - Current
- Contributed to a positive work environment with strong interpersonal skills and proactive teamwork attitude.
- Handles member questions regarding group health and wellness solutions and requirements.
- Engage perspective participants in a discussion around program benefits and enrollments for health and wellness services.
- Handles referrals from providers/members
- Provides navigation/support for member portal interaction.
- Schedules initial appointments for members.
- Administer member satisfaction surveys.
- Assist in the documentation of departmental procedures.
- Answered incoming phone calls to process requests, transfer calls, or relay messages to appropriate personnel.
- Worked closely with management to provide effective assistance for specific aspects of business operations.
Provider Enrollment Serv Rep
Blue Cross Blue Shields
04.2022 - Current
- Assist and perform enrollment and data management.
- Managed enrollment processes for Medicare Advantage and BCN Providers, ensuring over 95% accuracy in data updates and compliance with corporate guidelines.
- Resolved internal and external inquiries regarding provider registration and eligibility, achieving a 90% satisfaction rate in customer service metrics.
- Resolve issues and perform ongoing data updates.
- Analyze, evaluate, resolve and respond to providers inquires.
- Initiate status reports and service delays that occur in responding to inquiry.
- Organize work to meet departmental production and quality standards.
- Document providers contact through tracking systems following departmental procedures.
- Respond to providers inquires received via telephone through correspondence involving provider enrollment and data issues.
- Streamlined contract management by executing and finalizing members contracts using Icertis and DocuSign, contributing to the efficient operation of the PCO department
- Respond to correspondence involving a variety of providers enrollment for BCBSM and BCN product.
Administrative Clerical/ Insurance Specialist
Henry Ford Optimeyes
07.2015 - 04.2022
- Scheduling and managing the appointments for Optometrists.
- Preparing charts/medical records for doctor (s)
- Gathering medical records from other doctor (s) internal and external
- Registering new patients into the Acuity Logic/Exam writer Software systems
- Provided excellent patient services, while developing a relationship for long term loyalty
- Verification of medical and vision insurance for patient eligibility
- Securing authorizations/referral for office visits and treatments
- Investigates and resolve patient inquiries concerning insurance and billing in person or over the phone.
- Accurately and legibly records patient information, and appointments for eye exams.
- Provided structure and organization to improve a successful Work environment.
- Displayed effective leadership skills during the busiest times of the year.
- Answered phones, Cashier, and filing of paperwork and handled inventory.
- Tracked format reports using Microsoft Excel
- Enhanced customer satisfaction by addressing insurance-related inquiries and resolving issues promptly.
- Processed eligibility and benefits verification and authorization requests.
Education
Bachelor of Science - Information Technology
University of Phoenix
Southfield, MI06.2010
Skills
- Microsoft Office, Word, Excel, PowerPoint, Outlook, Microsoft Windows, Microsoft Word Access, Outlook
- Time management
- Team collaboration
- Verbal and written communication
- Portico
- Macess
- Sharepoint
- Data Analytics
- OneNote
- Crosswalk
- Medicare Advantage
- CM Web Client
Timeline
Health and Wellness Engagement Assistant
Blue Cross and Blue Shield
12.2023 - Current
Provider Enrollment Serv Rep
Blue Cross Blue Shields
04.2022 - Current
Administrative Clerical/ Insurance Specialist
Henry Ford Optimeyes
07.2015 - 04.2022
Bachelor of Science - Information Technology
University of Phoenix
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