Tara Taylor
Fairmont,WV
Summary
Objective-driven professional seeking to develop a successful career with a reputable company. Committed to leveraging skills in a way that benefits both employer and self. Possessing a strong set of strengths and attributes that make highly qualified for this position, brings a positive attitude, professionalism, and strong ethical values to thrive in a fast-paced environment. Excels at following directives and executing all necessary steps to succeed in high-pressure situations.
Overview
15
15
years of professional experience
Work History
Elite GSO
United Healthcare Group
02.2023 - Current
- Enhanced claim accuracy through detailed reviews.
- Assigned requests to the appropriate department.
- Reviewed INN & ONN deductibles.
- Clarified key aspects of the plan such as deductibles, benefits, and co-pay structures.
- Gathering necessary information for balance billing claims
- Conducted precise analysis of both CPT Codes and ICD codes.
- Executed claims procedures aligned with benefit structures.
- Reaching out to pharmacist for Rx claims processing
- Contacted providers to correct claims.
- Maintained a focused commitment to handling all phases of member issue resolution.
Senior Health Advocate4Me
United Healthcare Group
05.2022 - 02.2023
- Analyzed and processed claim submissions to ensure accuracy.
- Forwarded issues to designated teams ensuring seamless handling.
- Assessed annual and historical OPP Maximums alongside INN & ONN deductibles.
- Educated members on plan benefits, deductibles, co-pays, and co-insurance.
- Compiled required information to process balance billing claims.
- Reviewing CPT Codes, ICD codes
- Verified and executed claim processes aligned with designated benefits.
Client Operations, Trainer, Customer Experience
Teleperformance
08.2022 - 01.2023
- Facilitated skill-building workshops emphasizing M&R Core and intricate modules.
- Conducted training sessions for new hires to learn necessary software.
- Provided various knowledge sources as reliable references.
- Developed customer service skills among advocates.
- Skilled in articulating benefits and assessing claims procedures.
UHC FMT Outbound Customer Experience Specialist
Teleperformance
07.2020 - 10.2022
- Executed inbound and outbound calls for member accounts.
- Assisted with appeals and advocated for members across MAPD/MA plans, D-SNP plans Employer group plans and PDP plans.
- Handled quality care grievances with attention to detail.
Client Operations Representative Customer Experience: M&R Complex
Teleperformance
06.2022 - 08.2022
- Supported claim management, benefit resolution, appeal processing and grievance submission for member assistance.
- Coordinated Medicare eligibility assessments within designated areas.
Client Operations Representative Customer Experience
Teleperformance
03.2022 - 06.2022
- Managed over-the-counter product requests promptly.
- Managed timeframes for shipments, ensuring alignment with organizational policies.
C&S Core Customer Experience Specialist- Outbound
United Healthcare Group
01.2022 - 04.2022
- Utilized telephone, online chat, and email platforms to deliver outstanding customer service.
- Enhanced customer satisfaction by addressing and resolving issues in a timely manner.
- Monitored customer feedback, identifying trends to improve product offerings and the overall customer experience.
- Addressed customer inquiries, concerns, and complaints by providing solutions and alternatives and followed up to confirm resolution.
- Built rapport with customers by consistently delivering excellent service, fostering long-term loyalty.
- Created a knowledge base for staff members that provided quick access to important company information, frequently asked questions, and troubleshooting guides; this resource served as an invaluable tool in helping employees quickly resolve customer queries.
Client Operations Supervisor, Team Leader, Customer Experience
Teleperformance
10.2021 - 04.2022
- Directed activities and performance of 18-21 advocates in the UHC Outbound Team.
- Recorded advocates' time entries accurately.
- Enhanced call performance through advocate coaching.
- Monitored and logged all equipment changes for accuracy.
- Clarified objectives and outlined precise goals.
Office Administrator / Administrative Assistant
PKS Taxes LLC
01.2020 - 03.2020
- Prepared and maintained expense records, spreadsheets, and monthly reports using MS Office.
- Contributed to the safeguarding of proprietary data through careful document collection and management.
- Executed general administrative functions including scanning, filing, and mailing correspondence.
- Provided courteous support to clients seeking book information, statements, and payment assistance.
- Created formal statements for dispatch by mail to property stakeholders.
Sale Associate
Factory Fireplace & Flooring
09.2009 - 04.2010
- Enhanced customer experiences by promoting positive interactions in the Factory Fireplace & Flooring showroom.
- Created comprehensive price lists in alignment with market standards.
- Enhanced efficiency using QuickBooks for managing inventory.
Education
Associates Degree - Paralegal Studies
Pierpont Community & Technical College
Fairmont, WV05.2015
Skills
- Legal writing
- Coding
- Interpersonal skills
- Lexis Nexus
- Westlaw
- MS Office
- Secretarial
Accomplishments
- Generated, typed, formatted and edited letters, documents, motions, briefs and client forms
Internship
Hodges & Riffle LLC, 09/04/14, 11/20/14
Timeline
Elite GSO
United Healthcare Group
02.2023 - Current
Client Operations, Trainer, Customer Experience
Teleperformance
08.2022 - 01.2023
Client Operations Representative Customer Experience: M&R Complex
Teleperformance
06.2022 - 08.2022
Senior Health Advocate4Me
United Healthcare Group
05.2022 - 02.2023
Client Operations Representative Customer Experience
Teleperformance
03.2022 - 06.2022
C&S Core Customer Experience Specialist- Outbound
United Healthcare Group
01.2022 - 04.2022
Client Operations Supervisor, Team Leader, Customer Experience
Teleperformance
10.2021 - 04.2022
UHC FMT Outbound Customer Experience Specialist
Teleperformance
07.2020 - 10.2022
Office Administrator / Administrative Assistant
PKS Taxes LLC
01.2020 - 03.2020
Sale Associate
Factory Fireplace & Flooring
09.2009 - 04.2010
Associates Degree - Paralegal Studies
Pierpont Community & Technical College
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