Tanisha Suttles
Cincinnati,Ohio
Summary
Knowledgeable and dedicated customer service professional with 20 years in the industry. Solid team player with outgoing, positive demeanor and proven skills in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success.
Overview
19
19
years of professional experience
Work History
Service Consultant
Western & Southern Financial Group
Cincinnati, OH
05.2019 - Current
- Responds to high volume of inbound and outbound calls to clients, agents, 3rd parties and subsidiaries regarding resolving client inquiries.
- Provides information about service procedures and expected timelines.
- Initiates policy holder requests to make payments, forms request for beneficiary changes, loans, dividends, partial surrenders, full cash surrenders, policy transfer/exchanges and death claims.
- Responds to client requests via email, fax and regular mail. Provides written correspondence efficiently while meeting production metrics.
- Assist clients and their family via lobby visits.
Claims & Customer Service Specialist
Chard-Snyder
Cincinnati, OH
10.2016 - 05.2019
- Managed high call volume while maintaining a courteous and professional demeanor.
- Examine, review, process, calculate and pay claims in a timely manner based on claim information, plan design, insurance filings, documentation and reports.
- Ensured timely follow-up on pending cases, reducing the number of unresolved issues significantly over time.
- Educated customers about available resources such as online FAQs or user guides that could help them resolve future concerns independently.
Eligibility Technician
Hamilton County Department Of Job And Family Services
Cincinnati, OH
01.2015 - 08.2015
- Reviewed applications to determine client's eligibility for cash, food and other applicable assistance.
- Interviewed applicants/recipients to determine their eligibility for all public assistance program (including food assistance) through office or home visits.
- Prepared and maintained case records regarding applicant/recipient eligibility status for assistance programs to include address changes, household composition, assistance needs, resources and income and other necessary entries.
- Processed corrections in cases identified by quality control.
Grievance & Appeals Specialist
Humana
Cincinnati, OH
02.2008 - 10.2013
- Collected data pertaining to written appeals.
- Assisted with member and provider resolution, claims payment and direction, benefits, and network adequacy.
- Provided education on plan documents, health resources and guidance programs.
- Coordinated complex plan discrepancies with various departments, locations and divisions.
- Participated in cross-functional problem solving. Maintained a continuous incoming caseload of 40 or more.
Customer Service Representative
Humana
Cincinnati, OH
07.2005 - 02.2008
- Handled customer inquiries and suggestions courteously and professionally.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Developed an understanding of DX, ICD9, and HCPC and CPT coding.
- Assisted with coordination of benefits with other major insurance companies.
- Operated a PC/image station to obtain and extract information; documents information, activities and changes in the database.
Education
Associate of Applied Science - Health Care Administration
Brown Mackie College
Cincinnati, OH11.2010
Skills
- Customer Service
- Attention to Detail
- Listening Skills
- Multitasking and Organization
- Communication
- Team Collaboration
- Data Entry
- Conflict Resolution
- Performance Goals
Timeline
Service Consultant
Western & Southern Financial Group
05.2019 - Current
Claims & Customer Service Specialist
Chard-Snyder
10.2016 - 05.2019
Eligibility Technician
Hamilton County Department Of Job And Family Services
01.2015 - 08.2015
Grievance & Appeals Specialist
Humana
02.2008 - 10.2013
Customer Service Representative
Humana
07.2005 - 02.2008
Associate of Applied Science - Health Care Administration
Brown Mackie College