Tiyana Daniels
Greensboro
Summary
Professional with strong background in customer interactions and service solutions. Highly skilled in conflict resolution, communication, and problem-solving, ensuring customer satisfaction and loyalty. Effective team collaborator, adaptable to changing needs, and consistently focused on achieving results through efficient and empathetic service. Known for reliability and proactive approach to meeting customer and organizational goals.
Overview
7
7
years of professional experience
Work History
Customer Service Representative
Cigna
10.2025 - Current
- Assisted customers with inquiries, providing accurate information and solutions.
- Managed customer accounts, ensuring data accuracy and compliance with company policies.
- Assisted patients/members with insurance inquiries, claims status, and coverage benefits.
- Documented interactions and followed up on unresolved claim issues.
- Handled a high volume of calls while maintaining empathy and professionalism.
- Protected confidential information and demonstrated strong attention to detail.
Call Center Representative
The Ritz-Carlton Hotel Company
10.2023 - 04.2025
- Provided exceptional customer service to guests, resolving inquiries and concerns effectively.
- Utilized hotel management software to log guest interactions and update reservations accurately.
- Supported cross-departmental communication to facilitate seamless guest experiences throughout their stay.
- Resolve customer issues by identifying needs and providing effective solutions.
- Manage high call volumes, ensuring timely responses and customer satisfaction.
Claims Processor
All Care to You
02.2019 - 09.2023
- Review and analyze submitted medical claims to ensure accuracy and benefit eligibility.
- Enter and update claim data with 98%+ accuracy while maintaining productivity standards.
- Communicate with providers, pharmacies, and members to clarify claim information.
- Maintain strict compliance with HIPAA and company policies.
- Process adjustments, re-bill claims, and document outcomes in claim systems.
- Communicated directly with policyholders to gather necessary information for claims processing.
Education
Associate Degree in Nursing - Medical Billing
University of Phoenix
Phoenix, AZ03-2023
Skills
- Customer service
- Active listening
- Eligibility & Benefit Verification
- Data entry
- Call center experience
- Claims Adjudication & Processing
- Medical Billing & Coding Knowle
- HIPAA Compliance
- Customer & Provider Support
Timeline
Customer Service Representative
Cigna
10.2025 - Current
Call Center Representative
The Ritz-Carlton Hotel Company
10.2023 - 04.2025
Claims Processor
All Care to You
02.2019 - 09.2023
Associate Degree in Nursing - Medical Billing
University of Phoenix