Tiffiney Schraml
Archie
Summary
Dedicated and motivated professional committed to enhancing business performance through knowledge sharing and skill development. Demonstrates adaptability and a robust work ethic, thriving in both independent and collaborative environments to support organizational objectives. Resourceful and results-oriented, passionate about driving growth and efficiency while consistently seeking innovative solutions to meet company needs and elevate service value.
Overview
18
18
years of professional experience
Work History
Client Service Partner
Cigna Healthcare Insurance
01.2024 - 07.2025
- Fostered strong client relationships through effective communication and timely issue resolution.
- Act as a helpful partner to the company's team by sharing specialized knowledge in healthcare.
- Advise clients about their benefits options and help plan their coverage.
- Identify problems and offer solutions by working closely with team members to make sure everyone’s goals and activities are aligned.
- Actively participate in on-site Enrollment Fairs to help share information about services and support educational efforts in the areas where there's high interest.
- Developed customized solutions to meet client needs and enhance service delivery.
- Analyzed client feedback to identify trends, driving enhancements in service offerings.
- Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
- Exhibited high energy and professionalism when dealing with clients and staff.
- Educated customers about billing, payment processing and support policies and procedures.
- Promptly responded to inquiries and requests from prospective customers.
- Investigate and resolve customer concerns, such as questions about authorizations, provider networks, claims, reimbursements, eligibility, benefits coordination, online application help, or working with vendors like DME, Evicore, Ashlink.
- Prepare reports to analyze clients’ products and account information, highlighting trends, tracks, and potential resolutions.
- Followed up with customers about resolved issues to maintain high standards of customer service.
- Liaised with sales, marketing, and management teams to develop solutions and accomplish shared objectives.
Healthcare Navigator/Cost Utilization Specialist/Enrollment Specialist
GEHA Healthcare Insurance
01.2008 - 01.2023
- Provide outreach and educational support to members seeking alternative coverage options
- Coordinate benefits, verify eligibility, and assist with provider searches
- Facilitate second opinions and community resource referrals, assist with pharmacy needs
- Serve as a trusted point of contact to ensure members feel heard, valued, and supported during potentially stressful situations
- Ensure that treatments are medically necessary, appropriate, and cost-effective by reviewing medical records, collaborating with healthcare providers, and making sure all regulatory requirements are met.
- Assess whether care aligns with established clinical guidelines and evidence-based practices, helping to ensure patients receive suitable and effective treatments.
- Work closely with healthcare providers to obtain pre-authorizations, resolve claims, communicate denial reasons, and provide necessary information for appeals and peer-to-peer discussions, promoting clear and consistent communication.
- Made independent decisions based on knowledge of enrollment procedures, NAIC and Medicare rules, and the Federal Employee Health Benefits Manual.
- Educated members on healthcare benefits, promoting informed decision-making regarding coverage options.
- Engage actively in on-site enrollment fairs to disseminate information regarding available services and to support educational initiatives in regions exhibiting high demand.
Education
Associate of Science Degree -
Longview Community College
Lee’s Summit, MOSkills
- Proficient in Salesforce
- Proficient in conflict management
- Collaborative team contributor
- Community health engagement
- Health promotion and advocacy
- Ability to adjust to new challenges
- Interpersonal engagement skills
- Self-driven responsibility
- Effective prioritization techniques
- Product and service sales
Timeline
Client Service Partner
Cigna Healthcare Insurance
01.2024 - 07.2025
Healthcare Navigator/Cost Utilization Specialist/Enrollment Specialist
GEHA Healthcare Insurance
01.2008 - 01.2023
Associate of Science Degree -
Longview Community College