Tia Thomas Coe
Rincon,GA
Summary
Experienced professional with over 5 years in non-clinical operations, specializing in member services, patient support, and insurance navigation. Proven ability to enhance customer satisfaction and streamline processes in claims and service environments. Committed to delivering exceptional service and support in a claims/service representative role.
Overview
11
11
years of professional experience
Work History
Substitute Teacher
ESS
Rincon, GA
07.2024 - Current
- Managed classroom behavior to create a positive learning environment that enhanced student engagement.
- Delivered clear instructions to facilitate students' successful completion of academic work.
- Provided constructive feedback on student performance to support educational growth and deepen understanding.
Corporate/Government Card Member Service Rep.
US Bank NA
Remote- Rincon, GA
09.2021 - 08.2023
- Managed large volumes of incoming calls while maintaining productivity and quality standards.
- Delivered high-quality customer service by promptly addressing telephone inquiries and issues.
- Researched and resolved problems, including those related to business client fraud and internet operations.
- Researched various systems to resolve complex customer situations effectively.
- Guided and supported junior team members in skill development.
Medical Claims Specialist
Billing Solutions
Rincon, GA
01.2016 - 09.2021
- Verified insurance eligibility and benefits to ensure correct patient billing.
- Submitted primary and secondary claims while maintaining daily quotas for accuracy.
- Followed up with insurance companies on denied claims for prompt resolution.
- Corrected and promptly resubmitted rejected claims to minimize processing delays.
- Reconciled historic billing issues, significantly contributing to improved financial performance.
- Applied analytical and research skills to streamline claims processes.
- Assisted with non-clinical prior authorization workflows and conducted follow-ups.
- Documented interactions in CRM/EHR systems while adhering to HIPAA standards.
Non-Clinical Patient Support Representative
Care Core National
Bluffton , SC
09.2015 - 01.2016
- Managed incoming calls from physician offices and imaging centers to facilitate care management.
- Processed clinical certification requests for radiological services accurately and efficiently.
- Handled inquiries related to existing case statuses, providing timely and accurate updates.
- Conducted thorough research to resolve pre-certification issues promptly.
- Delivered professional and courteous information to callers, enhancing overall satisfaction.
- Provided clear explanations of appeals and reconsideration policies to members.
- Directed calls to relevant departments for effective resolution.
- Conducted targeted screenings without the need for clinical assessment.
Education
High School Diploma -
Effingham County High School
Springfield, GA05-2005
Certificate - Medical Billing And Coding Certification Training
AAPC
Distance Learning08-2026
Skills
- CRM systems proficiency
- Data entry accuracy
- Attention to detail in data entry
- Communication skills, written and verbal
- Multitasking and time management
- High-stress environment adaptability
- Adaptability to change
- Microsoft Word expertise
- Outlook and Cisco knowledge
- HIPAA/PHI compliance
- EOB and FSA knowledge
- Insurance claims identification
- CPT/ICD-10 code understanding
- Medical records organization
- Project management skills
- Typing speed of 70 WPM
- IVF, ICSI, and IUI proficiency
Timeline
Substitute Teacher
ESS
07.2024 - Current
Corporate/Government Card Member Service Rep.
US Bank NA
09.2021 - 08.2023
Medical Claims Specialist
Billing Solutions
01.2016 - 09.2021
Non-Clinical Patient Support Representative
Care Core National
09.2015 - 01.2016
High School Diploma -
Effingham County High School
Certificate - Medical Billing And Coding Certification Training
AAPC