Tyreisha Poole
Fort Worth,TX
Summary
Motivated and detail-oriented professional with a strong background in insurance claims processing, case documentation, and patient care. Skilled in data entry, customer service, and managing high-volume case loads while maintaining confidentiality and accuracy. Proficient in healthcare and insurance software including Epic, Salesforce, Availity, and Microsoft Office Suite . Experienced in verifying coverage, resolving billing issues, and supporting patients and clients through complex claim and care processes.
Overview
6
6
years of professional experience
Work History
Mental Health Care Coordinator
Millwood Hospital
01.2025 - Current
- Supported patient care by coordinating mental health services, scheduling appointments, and ensuring follow-up on treatment plans.
- Managed client caseloads, maintaining regular contact to monitor progress and address immediate needs.
- Processed insurance claims, authorizations, and billing issues to ensure timely reimbursement.
Patient Care Coordinator
Humana
08.2024 - 01.2025
- Coordinated patient care plans, ensuring timely referrals, authorizations, and follow-ups across providers and services.
- Served as primary point of contact for patients, assisting with benefit questions, appointment scheduling, and care navigation.
- Managed caseloads of members with chronic or complex conditions, supporting care coordination and wellness initiatives.
Claims Specialist
Luminare
01.2022 - 04.2024
- Performed high-volume, accurate data entry into claims management systems, maintaining confidentiality and compliance (HIPAA).
- Investigated complex or flagged claims, coordinating with providers, policyholders, and internal departments for resolution.
- Communicated claim determinations and benefit details to members and providers with clarity and professionalism.
Member Advocate
TTEC
10.2019 - 01.2022
- Served as a primary point of contact for members, providing guidance on benefits, claims, and coverage options.
- Assisted members in navigating the healthcare system, including scheduling, referrals, and understanding treatment options.
- Researched and resolved complex member issues, including claim denials, billing disputes, and eligibility concerns.
Education
High School Diploma -
Dumas High School
Skills
- Case documentation
- Crisis intervention
- Records management
- Claims processing
- Claims investigation
- Critical thinking skills
- HIPAA compliance
- Problem-solving
- Data entry
- Attention to detail
- Case management
- Time management
Timeline
Mental Health Care Coordinator
Millwood Hospital
01.2025 - Current
Patient Care Coordinator
Humana
08.2024 - 01.2025
Claims Specialist
Luminare
01.2022 - 04.2024
Member Advocate
TTEC
10.2019 - 01.2022
High School Diploma -
Dumas High School
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