Tisha Wilson

• Coordinated education briefings for service members, retirees, veterans and eligible family members in large and small group settings with question/answer sessions.
• Presented or participated in over 50 events per month/over 600 events per year assisting in providing information regarding medical plan options, benefits, and resources to more than 25,000 beneficiaries annually.
• Compiled pre and post briefing event data in designated databases, submitted required reports, and maintained event attendance records for tracking purposes.
• Presented and hosted health coverage webinar training sessions for service members and eligible family members.
• Worked directly with the Military Treatment Facility to successfully resolve enrollment problems, referral/authorization issues and to address military customer complaints as liaison.
• Conducted monthly face to face meetings with providers to solicit participation in various health initiatives to improve Healthcare Effectiveness Data and Information Set scores, provide health coverage education and identify potential issues.

TRICARE Enrollment and Benefit Specialist 01/2005 to 3/2014-Accepted position as TRICARE Education Specialist 3/2014

• Assisted more than 4,500 beneficiaries annually with health coverage inquiries and benefit education.
• Researched and resolved enrollment, billing, claims, and referral/authorization issues of beneficiaries through collaboration, root cause analysis, problem solving and resolution management on a walk in basis.
• Hand selected by administrator to address the most complicated ongoing claims issues due to the ability to get to the root cause of the issues and resolve them.
• Implemented process to track verification of all submitted enrollment forms for processing accuracy and corrective action taken when necessary.
• Collaborated with team to reassign 3,000 active duty family members from civilian primary providers to the Military Treatment Facility. 
• Accurately documented all beneficiary encounters in designated system.
• Supported receptionist when needed and de-escalated stressful situations with agitated beneficiaries when necessary. 
• Trained and mentored new associates in all functions of the TRICARE Service Center enabling them to provide outstanding customer service.
• Assisted in the process and delivery of Clearly Legible Reports to the Military Treatment Facility with a 90-95% retrieval rate.

• Provided on-site customer service support to TRICARE Service Center walk in customers with enrollment, benefits and claims inquiries.
• Utilized office equipment including fax machine, copier, computer and software to include MS Office.

• Assisted beneficiaries with new enrollments, changes to enrollments, fee payments and claims issues on a walk in basis within the TRICARE Service Center as well as by phone through the on-site call center.
• Educated beneficiaries regarding their medical benefits as well as government policies and procedures.

• Registered patients upon check in and retrieved medical records.
• Filed medical reports and documents in patient medical records.
• Applied ICD and CPT codes to services obtained for insurance purposes.
• Completed end of day statistical reports regarding patient load providing data for management.
• Scheduled patient appointments through on-site call center.