Tara Stearns
Plattsmouth
Summary
Dynamic professional with extensive experience at Community Plan-Medicare & Medicaid, excelling in claims and appeals management. Proven ability to enhance customer satisfaction through effective problem-solving and analytical thinking. Skilled in utilizing various software systems, ensuring compliance, and training staff to uphold high-quality standards in service delivery.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Sr. Provider Service Advocate
Community Plan-Medicare&Medicaid
Omaha
09.2021 - 01.2025
- Documented interactions in accordance with regulatory guidelines and policies.
- Monitored inquiries and complaints to maintain high standards of customer service.
- Assisted customers by troubleshooting technical issues to resolve service problems.
- Developed strong customer relationships through proactive outreach initiatives.
- Participated in team meetings to identify departmental challenges and propose solutions.
- Provided training for new staff on company policies regarding service delivery.
Histotechnologist
Clinical Pathology
Omaha
11.2018 - 10.2020
- Prepared and processed tissue samples for histological examination.
- Stained slides using various histological techniques and reagents.
- Operated and maintained laboratory equipment for specimen analysis.
- Trained junior staff on histological procedures and lab protocols.
- Ensured compliance with safety regulations and quality control standards.
- Documented procedures and results in laboratory information systems for tracking.
- Participated in continuing education programs related to histotechnologist duties.
Histotechnologist
University Of KS
Kansas City
04.2013 - 04.2018
- Navigation of Complex Computer Systems while meeting high Metrics, with 100% Quality
- Collaborated with pathologists to ensure accurate diagnoses.
- Trained junior staff on histological procedures and lab protocols.
- Participated in research projects involving clinical trials or new diagnostic techniques.
- Reviewed patient records and prepared slides for interpretation by a physician.
- Developed standard operating procedures for histology processes within the lab.
Education
Bachelor's Science B.A.M - Business Management
WGU
Remote Program, NE01-2026
Associates - Histotechnologist Program
Indiana University Purdue University of Indianapolis
Remote Program, KS01.2011
Highschool Diploma -
Truman Sr. High School
Independence, MO01.2000
Skills
- Claims
- Appeals
- Microsoft Teams Support
- Medicare/Medicaid Remote Customer Service Support
- Live Calls
- Chat Data Review
- Entry Excel
- O2
- Co-path
- Sunquest
- Open Specimen
- Redcap
- I-Lab
- Halo Software
- Indica Labs
- Complaint handling
- Problem-solving
- Analytical thinking
Certification
HT, ASCP (Histotechnologist), 24568
References
- Alicia Klein, N.P., One Medical, 970-331-3621
- Jennifer Bales, Remote Navigator Centene, 816-401-8527
Awards
- KU Cancer Center Employee of the Quarter, 2018
- United HealthCare Service Hero Nomination, 2023
Leadership Experience
Delivery Assistant Support in Operational Training for Community Plan. Claims review, Appeals, Support for all Provider types in Medicare & Medicaid plan for all states. Performance measured by AI, 100% Quality.
References
References available upon request.
Timeline
Sr. Provider Service Advocate
Community Plan-Medicare&Medicaid
09.2021 - 01.2025
Histotechnologist
Clinical Pathology
11.2018 - 10.2020
Histotechnologist
University Of KS
04.2013 - 04.2018
Bachelor's Science B.A.M - Business Management
WGU
Associates - Histotechnologist Program
Indiana University Purdue University of Indianapolis
Highschool Diploma -
Truman Sr. High School