Tiarra Butler
Hutto,TX
Summary
Dedicated and detail-oriented Quality Assurance professional with 7 years of experience in the healthcare insurance industry. Seeking a challenging position in a reputable organization where I can utilize my skills and experience to ensure the delivery of high-quality healthcare services and satisfaction to customers.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Quality Assurance Analyst
OmniCare365
10.2022 - Current
- Implemented a new customer feedback system resulting in a 20% increase in overall customer satisfaction scores within six months
- Supported company in maintaining work environment focused on quality, communication, collaboration, integration, and teamwork.
- Mentored and coached team members on QA topics and strategies.
- Gathered data on integration issues and vulnerabilities, reported findings and recommended improvements.
- Transportation Specialist Tier III-Assist with call que for Medicare Medicaid members call flow. Handling transportation reservations for members with Saferide benefits. Escalating tickets for any transportation issues and working with dispatchers.
- Provided timely transportation of diverse clients to healthcare facilities.
- Determined most effective mode and routing of materials to customer locations and company facilities.
- Analyzed transportation data to identify improvement opportunities.
- Worked with service providers to resolve issues and correct delays.
Certified Healthcare Trainer
Omnicare365
04.2024 - 11.2024
- Mentored new hires, resulting in stronger staff development and increased productivity.
- Facilitated virtual, in-person and blended learning sessions.
- Developed job-specific competencies and performance standards.
- Provided coaching and mentoring to employees.
- Chat Support for over 2,000 Healthcare Advocates through MS Teams
Quality Assurance Specialist
Wipro
10.2021 - 07.2023
- Perform audits on recorded and live client interactions and provide evaluation feedback to call center agents through QMS.Educated employees on specific QA standards and confirmed maintenance of standards.
- Provided regular updates to team leadership on quality metrics by communicating consistency problems or production deficiencies.
- Highlight trends and red flags to the business for better improvements.
Insurance Specialist
Progressive Insurance
07.2019 - 09.2021
- Provided excellent customer service by addressing policyholder inquiries, resolving issues, and explaining coverage details. Handling all billing questions
- Processed insurance claims efficiently, ensuring accuracy and adherence to company policies
- Conducted policy reviews and assessments to identify coverage gaps and recommend suitable adjustments
- Educate insured customer in regards to their coverages to prevent any discrepancy with a claims process
- Collaborated with underwriters and agents to facilitate policy issuance and renewals
- Maintained high standards of customer service by building relationships with clients.
- Tracked pending authorizations to resolve discrepancies and avoid revenue loss.
QA Analyst
Humana
12.2018 - 06.2019
- Provided regular updates to team leadership on quality metrics by communicating consistency problems or production deficiencies.
- Developed and maintained quality assurance procedure documentation.
- Analyzed quality and performance data to support operational decision-making.
Escalation Account Supervisor
Teleperformance
02.2018 - 12.2018
- Managed a team of 10 customer service representatives, providing guidance and support to resolve escalated customer issues efficiently and effectively
- Monitored and analyzed customer feedback and trends to identify areas for improvement in products and services, resulting in a 45% increase in customer satisfaction ratings
- Demonstrated ability to effectively manage and resolve complex customer issues by escalating to the appropriate departments or senior management, resulting in improved customer satisfaction ratings
- Utilized strong problem-solving and decision-making skills to handle critical and high-priority customer escalations, resulting in minimized business impact and customer churn
Healthcare Advocate
Teleperformance
07.2017 - 02.2018
- Billing Specialist-Accepting payments from members for their monthly plan premium ( Credit Card Visa, Master, Discover; ACH payment from Bank) Setting up recurring payments from
member’s Credit Card, Bank, or selecting Social Security as their payment method. - Pharmacy Claims Specialist-Handling inbound calls regarding RX medication and/or claims. Re-processing submissions in addition to working with pharmacy claims database. Completing Pharmacy Mail Order Overrides for members.
- Using technology that includes Microsoft Excel, Microsoft Access, RX Nova, EDW, and PL/SQL developer
- Claims Processing Specialist-Educating member on medical claim statutes following organizational policies and procedures. Using Medical terminology, CPT-4 and ICD-10 coding & Medicare experience.
- Benefit Specialist-Verified eligibility and compliance with authorization requirements for service providers. Educating member on the type of policy they have that would require a Referral to see a Specialist; cost of services, monthly premium amount, copayments for services and Pharmacy copayments. Completing PCP changes for member based on state regulations Providing In Network and Out of Network benefits for procedures and or test the member may receive with a facility Litton Access- (CMS, Medicare, Medicaid Database)
- Web Specialist- Assisting Humana members, Employees, Agents, Commercial members, with their My Humana online portal access
Financial Aid Adviser
Blackboard
08.2015 - 11.2015
- Counseled students and parents about financial aid options and program details.
- Communicated with prospective students to illustrate available financial aid opportunities.
- Live Chats with all students in regards to financial and academic regulations questions. Assisting college university staff with human resources application process and help desk log in issues.
Client Service Professional
H&R Block
01.2014 - 04.2014
- Kept meticulous records of all client conversations, implementing new data into computer system each day.
- Participated in regular trainings and workshops to keep up-to-date on all company products and services.
- Key Holder
- Accepting payments for our services that we do from clients with Debit Credit, Check, and or Cash and always making sure our bookkeeping was update and deposits were made when
needed. - Answering all questions for clients in regards to preparing their return for Tax Specialist and return statutes
Education
Medical Administration & Billing and Coding - Medical
Gary Job Corps
San Marcos, TX06.2015
High School Diploma -
Robert M Shoemaker High School
Killeen, TX06.2009
Skills
- Escalations
- Training
- Transportation/Reservation Scheduling
- Data Protection Regulation
- Customer Service Support
- Chat Support
- Quality
- Medicare & Medicaid
- RX & Medical Claims
- Data Entry
- Microsoft Office
- ICD-10
- Windows
- Medical Terminology
- Financial Aid Services
- Technical Support
Accomplishments
- Received 2nd place in Shoemaker High School Step Team
- National Honor Graduate
- President of 2008 Prom Committee
Customersatisfaction
OmniCare365, 12/01/22, Implemented a new customer feedback system resulting in a 20% increase in overall customer satisfaction scores within six months.
Certification
- CMC - Certified Medical Coder
- CCS - Certified Coding Specialist
- Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA).
- Change Management Specialist (CMS) – Management and Strategy Institute.
Languages
English
Native or Bilingual
Timeline
Certified Healthcare Trainer
Omnicare365
04.2024 - 11.2024
Quality Assurance Analyst
OmniCare365
10.2022 - Current
Quality Assurance Specialist
Wipro
10.2021 - 07.2023
Insurance Specialist
Progressive Insurance
07.2019 - 09.2021
QA Analyst
Humana
12.2018 - 06.2019
Escalation Account Supervisor
Teleperformance
02.2018 - 12.2018
Healthcare Advocate
Teleperformance
07.2017 - 02.2018
Financial Aid Adviser
Blackboard
08.2015 - 11.2015
Client Service Professional
H&R Block
01.2014 - 04.2014
- CMC - Certified Medical Coder
- CCS - Certified Coding Specialist
- Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA).
- Change Management Specialist (CMS) – Management and Strategy Institute.
Medical Administration & Billing and Coding - Medical
Gary Job Corps
High School Diploma -
Robert M Shoemaker High School
Similar Profiles
Shantell BooneShantell Boone
Talent Acquisition Specialist at OmniCare365Talent Acquisition Specialist at OmniCare365
Lukeia SmithLukeia Smith
Customer Service Transportation Advocate at OmniCare365Customer Service Transportation Advocate at OmniCare365
Tammi RodriguezTammi Rodriguez
Healthcare Customer Service Advocate at Omnicare365Healthcare Customer Service Advocate at Omnicare365