Tanya Garner
Minneapolis,MN
Summary
Support day-to-day program operations with expertise in records management and resource coordination. Skillfully meet diverse needs and address issues to maintain efficiency and program outreach. Demonstrated success in building long-lasting relationships. Able to operate effectively in a highly sensitive legal environment.
Overview
24
24
years of professional experience
Work History
Member Experience Advocate
Blue Cross Blue Shield of MN
11.2020 - Current
- Resolved issues based on thorough investigations of concerns
- Must maintain a strict standard of confidentiality to ensure that our members protected health information is secure
- Referred unresolved customer grievances to designated departments for further investigation
- Assist management with projects as needed
- Responds to customer telephone inquiries within a call center environment.
- Counseled clients during emotionally challenging situations, offering empathy while maintaining professionalism.
- Worked effectively with fellow team members to coordinate effective solutions to any question or concern.
Underwriter Risk Analyst
UnitedHealth Group
06.2007 - 10.2019
- Investigate potential member and group eligibility fraud by reviewing relevant documentation
- Utilize PC application, internet resources and internal proprietary databases to track, analyze and conduct a thorough complex investigation
- Interpret group policy's, COCs, legislative and compliance regulation
- Communicate with all levels of internal and external customers, business partners and employees
- Complete special projects as assigned.
Senior Team Leader
CBSA Inc
06.2000 - 05.2007
- Assisted management in the hiring process and new team member training
- Provided customer service, including interacting with customers, answering customer inquiries and effectively handling any customer complaints
- Review medical claims status
- Informed customers on their health benefits, premiums and enrollment.
Education
Certificate in Medical Records -
University of Phoenix
Phoenix, AZ03.2017
Skills
- Inbound call management
- Current knowledge and understanding of HIPAA, ACA and PHI regulations
- Account updates
- Complaint investigation
- Cultural awareness
- Microsoft access, Word, Excel, Outlook, Windows 10, Ipro, Idea, Prime, Sharepoint, Highmark
- Knowledge of small business underwriting requirements
- Handles sensitive and confidential information in a telecommuting environment
- Analytical Reasoning
- Legal knowledge
- Document Review
Timeline
Member Experience Advocate
Blue Cross Blue Shield of MN
11.2020 - Current
Underwriter Risk Analyst
UnitedHealth Group
06.2007 - 10.2019
Senior Team Leader
CBSA Inc
06.2000 - 05.2007
Certificate in Medical Records -
University of Phoenix
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