Tara Catchpole
Cigna Healthcare
Oliver Springs,TN
1
Language
5
years of professional experience
Healthcare Professional with expertise in medical claims processing and coding terminology, including ICD-10-CM, CPT, and HCPCS. Delivered high-quality customer service and process improvements through strong communication and adaptability in fast-paced environments. Focused on enhancing operational efficiency in a Prior Authorization Specialist role.
Work History
Senior Customer Advocate
2 Years 4 Months- Resolved customer inquiries and complaints regarding insurance claims and benefits, enhancing customer satisfaction.
- Manage accounts and ensure claims are processed accurately according to provider contracts and patient
benefits.
- Adapt to fast-paced environments while maintaining complex inquiries through live chat and email, maintaining clarity and professionalism to foster positive customer relationships. with clarity and professionalism.
- Facet and proclaim trained
- Led resolution of complex customer inquiries, enhancing overall satisfaction and trust in services.
- Mentored junior advocates, improving team performance and fostering a collaborative environment.
- Developed streamlined processes for handling escalated issues, increasing efficiency in response times.
Prior Authorization Specialist
1 Year 6 Months- Conduct thorough assessments of incoming Service Request notifications to ensure compliance with medical
necessity protocols. - Redirect Review of Services inquiries to Clinical First Level Reviewers or Medical Reviewers when beyond
scripted capabilities. - Collaborated with healthcare providers to obtain necessary documentation for approval workflows.
- Managed a high volume of incoming calls, maintaining professionalism while effectively addressing the needs of callers seeking assistance with prior authorizations.
- Utilized electronic health record systems to verify patient eligibility and benefit information.
Customer Service Chat Representative
1 Year 2 Months- Resolved customer inquiries through live chat, ensuring timely and accurate responses.
- Utilized CRM software to track interactions and maintain customer records.
- Developed FAQs and knowledge base articles to streamline support processes for common queries.
- Escalated complex issues to appropriate departments for resolution, enhancing overall service efficiency.
- Provided product information and troubleshooting assistance, improving customer satisfaction ratings.
- Monitored chat performance metrics to optimize response times and service quality continuously.
Education
No Degree - Medical Coding CBC
- Honor Roll 2021 it was a 6-month medical coding program
GED
Skills
Claims processing
Customer service
CRM management
Regulatory compliance
Medical terminology
Information gathering
Workflow optimization
Process improvement
Problem-solving
Analytical thinking
Attention to detail
Adaptability
Exceptional communication
Teamwork and collaboration
Conflict resolution
Interpersonal skills
Customer engagement
Microsoft Office
Regulatory compliance
Facet and proclaim
Languages
English
Full Professional
Timeline
Senior Customer Advocate
Cigna Healthcare
04.2024 - CurrentRead More
Prior Authorization Specialist
EviCore Healthcare Formerly Care Core National
10.2022 - 04.2024Read More
Customer Service Chat Representative
Kelly Connect
08.2021 - 10.2022Read More
Ross Medical Education Center
No Degree from Medical Coding CBC
Read More
Adult Eduction
GED
Read More