Tayla Rollins
West Palm Beach,Fl
Summary
Empathetic Grievance Coordinator known for high productivity and efficiency in task completion. Possess specialized skills in conflict resolution, policy interpretation, and communication strategies. Excel using active listening, problem-solving, and negotiation to address concerns and facilitate positive outcomes.
Overview
12
12
years of professional experience
Work History
Grievance Coordinator
Otis
West Palm Beach, Fu
02.2017 - Current
- Reviewed grievance appeals and verified case details against policy guidelines.
- Collected witness statements and supporting records for grievance investigations.
- Communicated with members, providers, and internal teams about case status.
- Monitored deadlines and follow-up actions for active grievance matters.
Medical Biller/Collector
Code Blue Billing, Inc.
Orlando, Florida
07.2019 - 01.2025
- Processed health claims with the understanding of coordination of benefits, subrogation, and eligibility criteria.
- Contact insurance companies to determine the proper handling and billing of appropriate insurance claims.
- Utilized various professional methods to collect outstanding debts related to billing issues.
- Recorded and documented billing issues systematically to enable traceability and facilitate resolution by team members.
- Researched and resolved appeals, disputes, grievances, and complaints.
OD Technician
Stanton Optical
West Palm Beach, FL
02.2015 - 01.2017
- Scheduled appointments and calibrated optical equipment, ensuring readiness for eye care procedures
- Fitted customers with prescription glasses and contact lenses, enhancing visual clarity and satisfaction
- Interpreted prescriptions for precise lens mounting and edging, contributing to optimal eyewear performance
- Scheduled appointments and Calibrated optical equipment for eye care clinic procedures
Education
AA Associate degree -
Valencia Community College
High School Diploma -
Palm Beach Gardens High School
Television and Film Magnet Program
Palm Beach Gardens High School
Skills
- Grievance investigation
- Appeals review
- Policy compliance
- Case management
- Medical claims processing
- Insurance claims
- Complaint resolution
- Deadline tracking
- Attention to detail
- Critical thinking
- Conflict resolution
- Written communication
- Member engagement
- Patient advocacy
Accomplishments
•Successfully managed and resolved high-volume member and provider grievances and appeals while meeting established turnaround times and regulatory deadlines.
•Demonstrated expertise in researching complex medical claims, reimbursement disputes, payment discrepancies, and claim adjudication issues.
•Prepared comprehensive appeal determinations and resolution letters in accordance with CMS, state, federal, and organizational guidelines.
Disclaimer
REFERENCE AVAILABLE UPON REQUEST
Timeline
Medical Biller/Collector
Code Blue Billing, Inc.
07.2019 - 01.2025
Grievance Coordinator
Otis
02.2017 - Current
OD Technician
Stanton Optical
02.2015 - 01.2017
AA Associate degree -
Valencia Community College
High School Diploma -
Palm Beach Gardens High School
Television and Film Magnet Program
Palm Beach Gardens High School