Temeka Worship
Rosharon,TX
Summary
Results-driven professional with extensive experience at Sedgwick Claims Management Services, specializing in utilization review and communication strategies that bolster operational efficiency and healthcare compliance. Demonstrated leadership at Advance America Cash Advance Center, where team management and process optimization led to significant performance improvements. Core competencies include strategic problem-solving, team leadership, and compliance management, with a commitment to driving organizational success.
Overview
18
18
years of professional experience
Work History
Utilization Review Coordinator
Sedgwick Claims Management Services
, Telecommuter
12.2014 - Current
- Conducted utilization review activities including concurrent reviews, retrospective reviews, and discharge planning.
- Analyzed medical records to ensure compliance with regulatory requirements.
- Participated in meetings with health plan representatives regarding utilization management policies.
- Maintained accurate data entry into a computerized system related to UR activities.
- Assisted with appeals processes related to denied claims or requests for additional information from payers.
- Responded promptly to inquiries from internal and external customers regarding authorization status or payment issues.
Customer Service II Associate/Dispatcher II
American Home Shield
Bartlett , Tennessee
06.2012 - 11.2014
- Received and dispatched calls for emergency services.
- Provided timely updates to customers regarding their orders or requests.
- Resolved customer complaints related to service issues or delays.
- Managed a large volume of phone calls while ensuring accuracy in data entry.
- Utilized computer systems to locate addresses, calculate estimated arrival times, and provide directions when necessary.
Virtual Contact Representative I
Sykes/AT&T Mobility
, Telecommuter
01.2012 - 06.2012
- Provided detailed information to customers regarding products and services offered by the company.
- Answered customer inquiries in a timely manner, both over the phone and via email.
- Processed orders for customers using an automated system.
- Created new customer accounts and maintained existing ones in accordance with established procedures.
Center Manager
Advance America Cash Advance Center
Memphis , Tennessee
04.2011 - 06.2012
- Conducted regular staff meetings to ensure all personnel were properly trained on policies and procedures.
- Established customer service standards for the center and monitored performance of staff against those standards.
- Managed day-to-day operations of the center, including staffing, scheduling, budgeting, inventory control and customer service.
Assistant Manager
Fairfield Inn & Suites by Marriott
Memphis/Nashville , Tennessee
03.2007 - 04.2011
- Assisted in the development of operational strategies to ensure efficient and productive operations.
- Supervised daily operations including scheduling shifts, assigning duties.
- Provided guidance and support to junior staff members on daily tasks, projects, and objectives.
- Coordinated with other departments to ensure smooth flow of operations.
- Developed a system for tracking inventory and ordering supplies as needed.
Education
Associate in Arts - Business Administration
Strayer University
12-2025
Skills
- Physician consultations
- Documentation and reporting
- Compliance procedures
- Communication
- Utilization review
- Utilization management
- Quality improvement
- Healthcare regulations
- Patient transfers and transitions
- Medical coding
References
References available upon request.
Timeline
Utilization Review Coordinator
Sedgwick Claims Management Services
12.2014 - Current
Customer Service II Associate/Dispatcher II
American Home Shield
06.2012 - 11.2014
Virtual Contact Representative I
Sykes/AT&T Mobility
01.2012 - 06.2012
Center Manager
Advance America Cash Advance Center
04.2011 - 06.2012
Assistant Manager
Fairfield Inn & Suites by Marriott
03.2007 - 04.2011
Associate in Arts - Business Administration
Strayer University
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