Tyra Alexander
Pickerington,OH
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
18
18
years of professional experience
Work History
Mail Carrier
USPS
10.2022 - Current
- Developed strong relationships with customers, providing exceptional service by addressing concerns promptly and professionally.
- Followed Postal Service policies and procedures to maintain integrity of mail and protect customer information.
- Responded to customer inquiries about delivery, forwarding and other postal services quickly to provide quality customer services.
- Obtains signatures for package deliveries as proof of delivery to avoid discrepancies.
Appeals and Grievances Coordinator
Centene
11.2019 - 06.2022
- Processed and finalized appeals and grievances within agreed-upon turnaround time.
- Remained knowledgeable regarding company policies and procedures and current developments within operational departments.
- Submitted verbal and written notification to members and providers.
- Improved member satisfaction by efficiently managing and resolving appeals and grievances cases.
- Contributed to the continuous improvement of departmental operations by regularly reviewing performance data, identifying trends, and recommending targeted action plans.
- Collaborated with interdisciplinary teams to review cases, identify trends, and develop strategies for addressing recurring issues.
- Demonstrated high-level attention to detail when reviewing medical records, provider contracts, and other relevant documents during case assessments.
Appeal Specialist
Sedgwick
07.2013 - 07.2019
- Gathers and reviews denied disability claim appeal documentation including, but not limited to, appeal request letters, medical documentation, medical consultant reviews, surveillance reports, independent medical evaluation reports and functional capacity evaluation reports.
- Improved claim resolution times by efficiently managing a high volume of appeals and coordinating with various departments.
Disability Representative, SR
Sedgwick
12.2012 - 07.2013
- Analyzes, approves and authorizes assigned claims and determines benefits due pursuant to a disability plan.
Disability Representative
Sedgwick
10.2011 - 11.2012
- Process claims and determines benefits due pursuant to a disability plan and FMLA.
GM Absence Management Administrator
Nationwide Better Health
01.2010 - 10.2011
- Provide accurate resolutions related to Federal, State, Disability and customer specific leaves.
Customer Services Representative
Nationwide Better Health
11.2006 - 01.2010
- Assisted employees with Family Medical Leave Act, researching and processing claims.
Education
No Degree - Business Administration
Franklin University
Columbus, OHHigh School Diploma -
South High School
Columbus, OH06.2001
Skills
- HIPAA Compliance Knowledge
- Professionalism and Ethics
- Continuous learning mindset
- Organizational abilities
- Medical Terminology Familiarity
- Medical coding knowledge
- Appeals Process Proficiency
- Time Management
Timeline
Mail Carrier
USPS
10.2022 - Current
Appeals and Grievances Coordinator
Centene
11.2019 - 06.2022
Appeal Specialist
Sedgwick
07.2013 - 07.2019
Disability Representative, SR
Sedgwick
12.2012 - 07.2013
Disability Representative
Sedgwick
10.2011 - 11.2012
GM Absence Management Administrator
Nationwide Better Health
01.2010 - 10.2011
Customer Services Representative
Nationwide Better Health
11.2006 - 01.2010
No Degree - Business Administration
Franklin University
High School Diploma -
South High School
Similar Profiles
Jocelyn ParksJocelyn Parks
Clerk at USPSClerk at USPS
Letrivia FasonLetrivia Fason
Lead Clerk/ Outbound Dispatch at UspsLead Clerk/ Outbound Dispatch at Usps
Ashley BradfieldAshley Bradfield
Rural Mail Carrier at USPSRural Mail Carrier at USPS
Mathilda BarteltMathilda Bartelt
PSE Clerk at USPSPSE Clerk at USPS
John PierceJohn Pierce
Community Center Director at Reynoldsburg Community ChurchCommunity Center Director at Reynoldsburg Community Church