TIFFANY BREWER
Southfield,MI
Summary
An ingenious and acclimatized individual with extensive expertise in Administration Core Competencies, Assembly and Call Center Operation’s Support: A creative problem solver, who shares knowledge, self-motivates and consistently meets the highest performance metric standards.
Flexible Customer Service Representative offering 15 years of success in resolving customer concerns and inquiries. Versed in accurately documenting call details and preparing reports. Committed to providing helpful answers and relevant information to retain clients.
Overview
14
14
years of professional experience
Work History
STD Examiner
Sedgwick CMS
Southfield, MI
11.2022 - Current
- Assisted claimants in understanding their rights and responsibilities throughout the application process, enhancing customer satisfaction levels.
- Served as a mentor to new hires during their orientation and training period, sharing expertise and providing guidance to ensure a successful transition into the role.
- Enhanced team performance by providing ongoing training and support to junior examiners in interpreting complex medical information.
- Handled sensitive personal information with discretion while adhering to strict confidentiality guidelines set forth by the client.
- Expedited decision-making process for disability claims by effectively managing a high-volume caseload under strict deadlines.
- Demonstrated adaptability when faced with policy changes or new legislation affecting the evaluation of disability claims, adjusting processes as needed without sacrificing accuracy.
- Ensured accurate benefit calculations for approved claims by meticulously reviewing medical, vocational, and financial documentation.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Reduced error rates by consistently applying critical thinking skills to analyze and interpret complex medical records and test results.
- Managed high caseloads effectively, ensuring all disability claims were processed promptly and accurately.
- Demonstrated attention to detail when reviewing medical records, enabling accurate assessment of functional limitations caused by disabilities.
- Supported the development of new claims management software, providing valuable input based on experience and expertise in disability claims handling.
- Played a critical role in resolving customer complaints by addressing concerns and providing clear explanations about claim decisions, maintaining positive relationships with clients.
- Self-motivated, with a strong sense of personal responsibility.
- Skilled at working independently and collaboratively in a team environment.
- Excellent communication skills, both verbal and written.
Seasonal Cabin Experience Agent
Delta Air Lines, Inc
Detroit, MI
09.2022 - Current
- Streamlined internal processes for improved efficiency and productivity within the agency.
- Delivered exceptional customer service by proactively addressing concerns and fostering a positive experience throughout all interactions.
- Consistently met compliance requirements for the agency by promptly completing mandatory continuing education courses and staying current on industry regulations.
- Responsible for cleaning lavatories and galleys on various aircrafts. Maintained an average clean score of 95%-100%.
- Maintained accurate records of client communications, transactions, policies, and other relevant documentation for seamless operations within the agency.
Payoff Specialist
Quicken Loans
Detroit, MI
02.2020 - 05.2022
- Obtained payoffs from Client's current bank by automated system or verbally requesting from a representative.
- Processed payoffs using the AMP Payoff Calculator.
- Spoke to clients in regards to the process and requesting any additional documents needed to obtain payoffs.
- Ordered and processed approximately 50-70 payoffs daily.
- Trained new hires.
Customer Service Specialist
Health Alliance Plan of MI
Detroit, MI
10.2013 - 02.2020
- Investigating and resolving claim adjudication inquiries/medical benefit discrepancies.
- Process payments, daily reconciliation and performed customer authentication methods (based on HIPAA compliance measures).
- Provide Customer Service analysis to members, ranging from verification of coverage, medical prior authorizations, daily operational volume of approximately 60-70 incoming customer calls daily.
- Responsible for OJM activities (On the Job Monitoring of new hires).
- Analyze and audit member financial institution specifications to ensure accuracy of for individual medical insurance plans (Off Marketplace, AHL, HMO and PPO policies).
Contact Center Customer Service Representative
Henry Ford Health System
Detroit, MI
09.2010 - 10.2013
- Assisted claimants in understanding their rights and responsibilities throughout the application process, enhancing customer satisfaction levels.
- Served as a mentor to new hires during their orientation and training period, sharing expertise and providing guidance to ensure a successful transition into the role.
- Enhanced team performance by providing ongoing training and support to junior examiners in interpreting complex medical information.
- Handled sensitive personal information with discretion while adhering to strict confidentiality guidelines set forth by the client.
- Expedited decision-making process for disability claims by effectively managing a high-volume caseload under strict deadlines.
- Demonstrated adaptability when faced with policy changes or new legislation affecting the evaluation of disability claims, adjusting processes as needed without sacrificing accuracy.
- Ensured accurate benefit calculations for approved claims by meticulously reviewing medical, vocational, and financial documentation.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Reduced error rates by consistently applying critical thinking skills to analyze and interpret complex medical records and test results.
- Managed high caseloads effectively, ensuring all disability claims were processed promptly and accurately.
- Demonstrated attention to detail when reviewing medical records, enabling accurate assessment of functional limitations caused by disabilities.
- Supported the development of new claims management software, providing valuable input based on experience and expertise in disability claims handling.
- Played a critical role in resolving customer complaints by addressing concerns and providing clear explanations about claim decisions, maintaining positive relationships with clients.
- Self-motivated, with a strong sense of personal responsibility.
- Skilled at working independently and collaboratively in a team environment.
- Excellent communication skills, both verbal and written.
Education
Eastern Michigan University
Ypsilanti, MIHigh School Diploma -
Renaissance High School
Detroit, Mi06.1993
Skills
- Customer Service
- Responding to Difficult Customers
- De-escalation Techniques
- Efficient and Detail-Oriented
- Understanding Customer Needs
- Data Entry and Maintenance
- Call Documentation
- Issue and Complaint Resolution
- Upselling Products and Services
- Verbal and Written Communication
- Customer Data Confidentiality
- Multitasking and Prioritization
- Calm and Professional Under Pressure
- Courteous with Strong Service Mindset
- Upbeat and Positive Personality
- Building Customer Trust and Loyalty
- Proficiency in Microsoft Office Software
Affiliations
Participant for internal L.E.A.N. process initiatives (Health Alliance Plan) (2015-2018); led various presentations outlining both the scope and depth of Health Alliance Plan’s Health Maintenance Organization (HMO plans) to our Executive Leadership Committee (Year 2016-2018) LEADERSHIP Current Board Member for W.I.T.T (We’re In This Together); A non-profit volunteer organization, geared towards social awareness and aiding those whom are statistically categorized as being disenfranchised.
Timeline
STD Examiner
Sedgwick CMS
11.2022 - Current
Seasonal Cabin Experience Agent
Delta Air Lines, Inc
09.2022 - Current
Payoff Specialist
Quicken Loans
02.2020 - 05.2022
Customer Service Specialist
Health Alliance Plan of MI
10.2013 - 02.2020
Contact Center Customer Service Representative
Henry Ford Health System
09.2010 - 10.2013
Eastern Michigan University
High School Diploma -
Renaissance High School