Tynetta M. Daniels
Snellville,GA
Summary
Detailed professional with strong technical skills and the ability to learn advanced concepts quickly. data entry operator with an excellent record of accuracy and client satisfaction. Strong ability to handle multiple projects with the highest degree of timeliness and efficiency. Dedicated professional eager to create and implement successful strategies to improve organizational efficiency. Adept at utilizing data analysis to provide insights into HR initiatives. Strong communication and interpersonal skills and committed to pursuing best practices related to employee development and retention.
Overview
8
8
years of professional experience
Work History
Sr. Claims Manager
Lincoln Financial Group
Remote
12.2022 - Current
- Assess the qualifications and allocate benefits for PNC employees with respect to short and long-term disability claims.
- Investigate, oversee, and resolve claims in a timely, impartial, and well-informed manner while adhering to company policies, state laws, and regulatory performance standards for The PNC.
- Establish and uphold appropriate claim decisions based on case facts and in line with Lincoln Financial policy.
- Conduct investigations and identify fraud to report to SIU.
- Evaluate and arrange scheduled, manual, STAT, commission, and company leave payments for employees each period.
- Supervise, motivate, and nurture Clinical Review Processing staff to achieve departmental targets and business objectives in handling claims requiring clinical review, while aiding in resolving complex issues.
- Establishe and execute objectives related to individual KPIs and competencies to ensure quality outcomes for customers and clients.
- Offer regular feedback to team members, communicate KPI status to the Manager monthly, and provides weekly updates and action plans as needed.
- Monitor daily workload reports, collaborate with Enterprise counterparts, and allocates workload and staff accordingly to maintain efficiency and meet performance expectations.
- Assist in ensuring compliance with clinical claims processing regulations, customer performance guarantees, and implements corrective actions when necessary.
- Provide coverage and claims analysis to management when requested and offer recommendations on disputed claims resolution.
- Understand dispute requirements, gather evidence to support claims, and prepare customer cases for appeals.
- Safeguard the confidentiality of patient finances, medical records, and health statuses.
Payroll/ Benefit Specialist
ADP
09.2021 - 12.2022
- Resolve customer problems and complaints in regard to payroll inquiries (Pay checks, Federal/State Taxes, Withholding, Direct Deposit)
- Answer questions regarding Earnings/Deductions, Garnishments, Retro Pay and Payroll inquiries
- Review customer accounts and maintain secure confidential profiles for employees
- Assist with annual enrollment and guide Retirees 65 and older setting up Medicare Part A and B and selecting Benefit plan options
- Provide Dental and Vision Plan options to eligible employees
- Set up Survivor Benefit and Life Insurance Plans
- My ADP Self Service Navigation/ Registration
- Navigate employees through Time Management systems (etime, Oracle, GTE) to edit timecards and time off requests
- Provide client policy information from internal systems (Siebel, SUI, Enterprise, Workday, Cimplicity)
- Perform password resets and assist with registrations and unlocks
- Handle payroll and tax issues for H&W and COS clients
- Verify employees through lexis nexus verification
- Order w2s through reissue system (MOE).
- Analyzed and reported on employee benefits data to identify trends and develop strategies for improvement.
- Observed strict procedures to maintain data and plan participant confidentiality.
- Collaborated with HR to develop and maintain up-to-date benefits manual.
- Verified and submitted timekeeping information for accurate and efficient payroll processing.
- Uploaded time records into computer system and made adjustments to create accurate database for payroll processing functions.
- Resolved payroll discrepancies quickly and successfully.
- Researched payroll errors and processed payments for federal and state taxes, social security, Medicare and various employee deductions, annuity contributions, and retirement plan withholdings.
- Confirmed compliance with all applicable federal, state and local payroll laws and regulations.
- Created new hire and termination documents for payroll.
- Developed and implemented new payroll policies and procedures according to changing laws and regulations.
Human Resource Manager
FT Transports
03.2019 - 07.2021
- Partner with management in the achievement of business goals and in the development and implementation of supporting human resource strategy and initiatives
- Manage effective relationships and communicate with management at all levels
- Ensure employee relations issues are properly identified, reported, investigated and resolved
- Promote a positive work culture by driving team engagement initiatives and employee advocacy
- Lead and manage subordinates including assignment and monitoring of work, development, communication, reward, and recognition and managing overall performance
- Manage the employee performance management and compensation process within the business unit(s)
- Facilitate leadership succession planning
- Support, facilitate and conduct employee development efforts
- Identify new development requirements to support business goals and objectives
- Implement processes and promote employee communication and rewards and recognition efforts throughout the business
- Develop, implement, and oversee efforts to promote diversity, outreach efforts and compensation equity
- Ensure management awareness of areas of underutilization and goals through communication and training; monitor and communicate progress.
- Coordinated employee grievances and disputes in timely and professional manner by finding constructive solutions.
- Maintained payroll and benefits for employees in various locations and diminished financial discrepancies through expert program management.
- Motivated employees through special events, incentive programs, and constructive feedback.
- Implemented performance reviews and motivational strategies to elevate HR team results.
- Organized and led staff orientation programs and training to promote collaboration.
- Recruited top talent to maximize profitability.
Customer Service Associate
State Farm
09.2019 - 03.2021
- Serve as the first point of contact for customers involved in accidents needing assistance
- Reporting and handling complex claims, identifying and ensuring prompt routing of claims through ECS system
- Investigate each claim to establish liability
- Set up rental cars for customer through vendors Hertz, Enterprise, and other local vendors
- Track fraud and investigate unusual activities in claims
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Verified client information by analyzing existing evidence on file.
Data Entry Specialist
Rushwork Logistics
01.2017 - 05.2019
- Assisted with the creation and organization of customer accounts by inputting data according to transportation policies
- Tracked quality, quantity, stock levels, delivery times
- Completed all requests within required timeframes while maintaining a high level of quality
- Maintained a 99% accuracy rate by assessing client and account documents for errors
- Execute and ensure on-time delivery of all necessary assessment packets
- Strong emphasis on working efficiently and accurately
- Core competencies include maintaining confidentiality, prioritizing, relationship building, customer service oriented, communication skills, contract negotiations, decision making, organization and planning skills, initiative and adaptability.
- Compiled data and reviewed information for accuracy prior to input.
- Reviewed and updated client correspondence files and database information to maintain accurate records.
- Corrected data entry errors to prevent duplication or data degradation.
- Managed workflow scheduling, data entry, and accuracy verification for large data projects.
- Scanned documents and saved in database to keep records of essential organizational information.
- Communicated with supervisors and colleagues to process data quickly and resolve discrepancies.
- Developed and maintained databases to store customer information.
Education
Mechanical Engineering - Engineering
Alabama A & M University
Skills
- Customer Accounts Quality Control
- Sales Force Taleo
- Marketing Organization Skills
- Pricing
- Auto CAD
- Solid Edge
- Microsoft Suites
- Time Management
- Payroll
- Demand Planning
- Networking and Partnership Development
- Microsoft Office
- Employment Data Tracking
- Leave of Absence Management
- Eligibility Determinations
- Database Maintenance
- Case Management
- Analytical and Critical Thinking
- Maintain Employment Records
Timeline
Sr. Claims Manager
Lincoln Financial Group
12.2022 - Current
Payroll/ Benefit Specialist
ADP
09.2021 - 12.2022
Customer Service Associate
State Farm
09.2019 - 03.2021
Human Resource Manager
FT Transports
03.2019 - 07.2021
Data Entry Specialist
Rushwork Logistics
01.2017 - 05.2019
Mechanical Engineering - Engineering
Alabama A & M University