TYELIA GOLDSMITH
Newburgh,NY
Summary
Detail-oriented individual with exceptional communication and project management skills. Adept at handling multiple tasks effectively and efficiently in fast-paced environments. Recognized for proactive approach to identifying and addressing issues, with focus on optimizing processes and supporting team objectives.
Overview
10
10
years of professional experience
Work History
Utilization Review Coordinator
ElderPlan
04.2024 - Current
- Identified potential areas of risk or non-compliance through regular audits, implementing corrective action plans as needed to mitigate concerns.
- Maintained confidentiality and security of patient data, adhering to all relevant privacy laws and regulations.
- Contributed to the development of policies and procedures related to utilization management, ensuring alignment with industry best practices.
- Increased efficiency of the utilization review process through regular communication with insurance companies for timely authorizations.
- Collaborated with case managers on patient assessments, identifying opportunities for improvement in care transitions and reducing avoidable delays.
Coordinator of Member Engagement
Evercare
01.2020 - 03.2024
- Conducted thorough assessments of member needs, enabling the development of relevant programming.
- Leveraged social media platforms to increase visibility of member benefits, driving increased participation in offerings.
- Organized and executed successful events for members, fostering a sense of community and collaboration.
- Handled phone calls related to members' accounts or general questions about products and services.
- Enhanced member satisfaction by promptly addressing concerns and providing tailored solutions.
Call Center Representative
Cornerstone Family Healthcare
10.2014 - 01.2018
- Managed high call volumes while providing exceptional customer support and maintaining professional composure.
- Handled escalated calls professionally, effectively resolving complex issues and ensuring client satisfaction at all times.
- Enhanced customer satisfaction by efficiently addressing and resolving inquiries in a timely manner.
- Participated in ongoing training and development, staying current on company policies, products, and procedures to deliver accurate information to customers.
Education
Bachelor's in Health Management - Business Administration And Management
DeVry University
Illinois City, ILSkills
- Front Office
- Receptionist
- Customer Service (6 years)
- Scheduling
- Computer Literacy
Timeline
Utilization Review Coordinator
ElderPlan
04.2024 - Current
Coordinator of Member Engagement
Evercare
01.2020 - 03.2024
Call Center Representative
Cornerstone Family Healthcare
10.2014 - 01.2018
Bachelor's in Health Management - Business Administration And Management
DeVry University