Strong leader and problem-solver. Independent decision-making skills and sound judgment to positively impact company success. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Hardworking and passionate Detail-oriented team player with strong organizational skills.
Hi, I’m
Tashyra Young
Summary
Overview
16
years of professional experience
Work History
Skygen Usa
Appeals And Complaints Specialist
03.2019 - Current
Job overview
- Analyze, research, and process appeal requests from members and providers regarding denied request for clinical services and or payment
- Communicated effectively with clients,members and providers in the investigation and resolution of various appeals complaints and grievances
- Documented all appeal, complaint and grievances activity for reporting and trending analysis
- Created formal correspondences to confirm receipt and provide resolution for members and providers complaints and appeal request
- Analyzed and process all inbound mail and emails for intake purposes
- Conducted quality control reviews on complaint data and addressed results with colleagues to influence positive change.
- Maintained strict compliance and regulatory stands for appeals and grievances turnaround times and documentation requirements
- Maintained a accuracy of 99 percent on resolved cases from start to finish
- Trained new personnel regarding department operations, policies and services.
- Process Medicare, Medicaid , DSNP and Cotiviti appeals and grievances within timely guidelines allotted by provider
Skygen Usa
Customer Support, Billing Support Remote
03.2018 - 03.2019
Job overview
- Continual inbound/outbound call support for medical dental and vision clients including Medicaid, Medicare, Commercial and Dental insurance for providers and members
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Consulted with outside parties to resolve discrepancies and create expert solutions.
- Researched and resolved billing discrepancies to enable accurate billing.
- Assisted with billing inquiries and provided timely responses to enhance customer satisfaction.
- Provided excellent customer service, developing and maintaining client relationships.
- Monitored customer accounts to identify and rectify billing issues.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Identified payment trends and adjusted billing processes accordingly to retain customers.
- Maintained strict call center guidelines including call quality, after call work,follow up time
- Processed check traces, reissued check payments
WeEnergies
Seasonal Customer Consultant
03.2017 - 10.2017
Job overview
- Open transfer and close customer residential accounts Refer customers to appropriate programs that exhibit hardship assisted customers with affordable payment agreements
- Provided exceptional customer service to high-volume customer base, resolving issues, answering inquiries and providing product information.
- Handled difficult customer situations with grace and professionalism, consistently meeting first-call resolution metrics.
- Assisted customers with product selection and troubleshooting, providing accurate information and guidance to foster satisfaction.
- Analyzed customer feedback and generated reports to identify trends and opportunities for improvement.
- Exhibited high energy and professionalism when dealing with clients and staff.
- Sought ways to improve processes and services provided.
- Educated customers about billing, payment processing and support policies and procedures.
- Mediate between customer and third parties services to arrange reconnection or disconnection of utilities
Northwestern Mutual
Loan and Surrender Claims Analyst
01.2016 - 12.2016
Job overview
- Viewed reports regularly to make sure processing was conducted efficiently.
- Maintained strict confidentiality with all personal data as per company guidelines.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
- Examined claims forms and other records to determine insurance coverage.
Fis
Fraud Claims Support
09.2014 - 12.2015
Job overview
- Worked productively in fast-moving work environment to process large volumes of claims.
- Analyzed and addressed escalated claims to resolve issues quickly.
- Followed up with customers on unresolved issues.
- Researched and analyzed complex claims to determine next steps and possible outcomes.
- Updated claims system to track claim status and provide relevant information to other department.
- Prepared and presented detailed reports to management on claims issues to aid in decision making.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
- Monitored real- time fraud ques that are populated due to fraud trend systems
- Evaluated spending trends of customer in accordance with fraud trends to determine if fraud was viable
- Disputed fraud claims within client regulations
Kohl's Corporation
Early Mid and Late-Stage Collector
10.2011 - 09.2014
Job overview
- Delivered exceptional customer service on collection calls and maintained calm and professional demeanor.
- Contacted customers to discuss payment schedules and set up or immediately process payments.
- Persistently reached out to customers with extremely past due accounts to recover lost revenue.
- Achieved performance goals on consistent basis.
- Trained new collections representatives on collections processes and incentivized team members to achieve production goals.
- Reached out to approximately 100-150 account holders daily.
- Documented changes in accounts and on credit reports.
- Negotiated to collect balance in full.
- Used skip tracing and other techniques to locate debtors.
- Registered information of customers on database, collecting credit history, financial statements and personal details to preserve accurate records.
Chase Home Finance
Underwriter/Credit Analyst
03.2008 - 09.2011
Job overview
- Approve and Deny mortgage loans due to mortgage standards and investor guidelines, Analyze current offers of purchase to determine if they are acceptable by investor, Working with financial documents, tax returns income profit and loss statements, credit reports
- Analyzing preliminary HUDs, title reports, purchase contracts, appraisals reports and credit reports, Key
- Contact source for real estate agents and attorneys, Ordering of Brokers Price Opinions, Appraisals (interior and exterior) credit reports and Title Reports, Meet
- Repayment Plan, Support mortgage lenders in continuously gathering information for loan applicants
- Key contact for customer during application and process , Set up of mortgage files in regards to all investors including
- FHA, Conventional, USDA,VA, Continuous documentation of file
Education
Walden University
B.S from Human Services Psychology
University Overview
Skills
- Data Quality
- Customer Relationship Management
- Microsoft Office
- Information Services
- Regulatory Compliance
- Policy and Procedure Adherence
- Call Volume and Quality Metrics
- Calm and Professional Under Pressure
- Customer Retention Strategies
- Customer Data Confidentiality
- Root Cause Analysis
- Understanding Customer Needs
Availability
See my work availability
Not Available
Available
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
There’s no shortage of remarkable ideas, what’s missing is the will to execute them.
Timeline
Appeals And Complaints Specialist
Skygen Usa
03.2019 - Current
Customer Support, Billing Support Remote
Skygen Usa
03.2018 - 03.2019
Seasonal Customer Consultant
WeEnergies
03.2017 - 10.2017
Loan and Surrender Claims Analyst
Northwestern Mutual
01.2016 - 12.2016
Fraud Claims Support
Fis
09.2014 - 12.2015
Early Mid and Late-Stage Collector
Kohl's Corporation
10.2011 - 09.2014
Underwriter/Credit Analyst
Chase Home Finance
03.2008 - 09.2011
Walden University
B.S from Human Services Psychology
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