Summary
Overview
Work History
Education
Skills
Certification
Languages
Awards
Core Competencies
Timeline
Generic

Tyja Arceneaux

Lafayette,LA

Summary

Experienced and detail-oriented Eligibility Representative with 5+ years of combined onsite and remote experience in verifying insurance coverage, determining patient program eligibility, and assisting members with healthcare access. Adept at navigating complex insurance systems, resolving eligibility discrepancies, and maintaining compliance with HIPAA standards. Proven ability to deliver accurate, compassionate support in high-volume call environments while maintaining productivity and quality metrics.

Overview

7
7
years of professional experience
1
1
Certification

Work History

Hotel Reservation & Customer Service Agent

HotelPlanner (Remote)
02.2021 - Current
  • Respond to high-volume inbound calls, emails, and chat inquiries with professionalism and accuracy.
  • Provide detailed information regarding room rates, amenities, and availability.
  • Process reservations, changes, cancellations, and resolve booking-related issues.
  • Apply customer service principles that align with eligibility representative expectations, including handling sensitive payment details and addressing client needs with empathy.
  • Maintain performance metrics while supporting guests across multiple time zones.

Eligibility Specialist (Healthcare Benefits)

Cigna Healthcare / TPUSA (Remote)
05.2018 - 02.2021
  • Reviewed healthcare applications to determine eligibility for coverage including Medicaid, Medicare, and employer-sponsored plans.
  • Verified critical applicant data (income, employment, residency, family composition) to confirm benefit status.
  • Communicated eligibility results to patients in a clear, concise, and empathetic manner.
  • Liaised with healthcare providers and insurers to ensure pre-authorization and benefit validation for upcoming medical services.
  • Maintained HIPAA-compliant documentation and met productivity standards in a fast-paced remote support setting.

Education

High School Diploma - undefined

Lafayette, LA

Skills

  • Microsoft Word, Excel, Outlook
  • Insurance Portals & Claims Systems
  • CRM & Call Center Software
  • Data Entry & Verification Platforms

Certification

Microsoft Office Certified

Languages

English (Fluent)

Awards

National Honor Society, Beta Club, Student Council

Core Competencies

  • Insurance Eligibility Verification
  • Medicaid/Medicare Screening
  • HIPAA Compliance
  • Healthcare Customer Service
  • Remote Call Center Support
  • Patient Advocacy & Education
  • Documentation & Data Entry
  • EMR/EHR System Navigation
  • Claims & Benefits Inquiry Resolution
  • Microsoft Office Suite

Timeline

Hotel Reservation & Customer Service Agent

HotelPlanner (Remote)
02.2021 - Current

Eligibility Specialist (Healthcare Benefits)

Cigna Healthcare / TPUSA (Remote)
05.2018 - 02.2021

High School Diploma - undefined

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