Tiera J. Chavis
Durham
Summary
Top-notch professional with extensive experience in job analysis and job evaluation. Skilled in conducting salary surveys and implementing compensation and benefits plans. Collaborative and committed to staying updated on best practices with expertise in providing exemplary service regarding benefits support. Multitasking Benefits Specialist knowledgeable in state and federal regulations and maintaining employee confidentiality.
Overview
16
16
years of professional experience
Work History
Benefit Verification Specialist
Cencora
10.2020 - Current
- Claims assistance, tracking and submission.
- Prior authorization assistance and tracking
- Processed Medicaid, medicare, Tricare and VA benefits
- Review and ensure compliance with PRMO
- Conduct benefit verification calls and provide results to HCPs.
- Collect estimated patient liabilities
- Assess patient eligibility for copay assistance.
- Assess patient eligibility for PAP.
- Advanced alternate coverage research.
- Appeals/Denials.
- Intakes and reports adverse events as directed.
- Experience with various insurance plans including requirements for referral, authorization, and pre-determination
- Experience making outbound calls to insurance companies to obtain insurance benefits related to health insurance, and/or discussing patient financial responsibilities.
- Knowledge with using Avaya-One X, Availity, Change HealthCare and/or CoverMyMeds.
- Experience with non-profit organization copay assistance programs.
- Monitors third party claims
Eligibility Verification Services (Temp position)
Conduent
04.2020 - 08.2020
- Pharmacy and Healthcare Benefits experience
- Processed Prior Authorizations.
- Experience with various insurance plans including requirements for referral, authorization, and pre-determination.
- Experience with reading, and understanding medical policy information, and estimated patient responsibility, taking into consideration pre-determination, referral, authorization, and contract terms
Workers' Compensation Case Manager
The Hartford
01.2019 - 05.2020
- Negotiates settlement of claims within designated authority.
- Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
- Receives, gathers and accurately transmits workers’ compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner.
- Generates checks for indemnity and medical payments daily.
Financial Services Representative
Durham Regional Hospital
11.2016 - 01.2019
- Assist with account analysis, coding, and reconciliation of account balances.
- Process time tracking records and payroll; prepare reports as required.
- Resolving claim edits
- Patient account representative
Customer Service Rep
Amazon
07.2015 - 11.2016
- Assisted customers with inquiries
- Answer calls
- Minor even planning for company
- Clerical work
- Customer service support
Customer Service/Office Assistant
Brooks Home Improvement
08.2014 - 06.2015
- Proficient in office duties, typing, filing, copying
- Greet customers and direct them to the appropriate person
- Schedule appointment for estimate
- Responsible for general office duties
- Responsible for customer support
- Skilled and experienced in handling customer’s orders
- Responsible for answering all incoming calls and taking messages
- Responsible for shipping and receiving orders
- Responsible for all filing, faxing, and copying
- Handle clients request and complaints in a timely, professional and courteous manner
- Part-time
Office Manager
The Hunt Law Firm
09.2013 - 05.2014
- Clerical work
- Answered calls, appointment scheduling
- Prepared mail to be sent out daily
- Assistant to owners of the firm
- Specialized in intake interviews for new cases
Dining Room Assistant
Chili’s Bar and Grill
01.2010 - 01.2012
- Hostess
- Greet Customers with friendly attitude
- Make sure order was taken and out at a reasonable time
- Responsible for to-go service
- Count cash drawer down at the end of shift
- Answered telephone
- Prepared restaurant for the next day
Education
High School Diploma - Early Childhood Ed.
Josephine Dobbs Clement Early College High School
Durham, NC05-2010
Associate of Arts - Human Resources Management
Durham Technical Community College
Durham, NC06-2014
Associate of Arts - Medical Assisting
Durham Technical Community College
Durham, NC05-2026
Skills
- Ability to work effectively
- Ability to interact, tactfully and courteously
- Ability to use MS Office
- Excellent organization skills, time management, and attention to detail
- Professionalism
- Performs other duties as assigned
- Strong customer service skills and experience in client support
- Excellent verbal and written communication abilities
Accomplishments
- 2010: Completed four years of high school in two years with two year of college credit
- Carolina State Counsel Spelling Bee Contest
- Greater Emmanuel Junior Church Queen
- Contestant in the North Carolina Miss Teen Pageant
- NC Credentials 1&2, SIDS, CPR, Medical Terminology and First Aid
Timeline
Benefit Verification Specialist
Cencora
10.2020 - Current
Eligibility Verification Services (Temp position)
Conduent
04.2020 - 08.2020
Workers' Compensation Case Manager
The Hartford
01.2019 - 05.2020
Financial Services Representative
Durham Regional Hospital
11.2016 - 01.2019
Customer Service Rep
Amazon
07.2015 - 11.2016
Customer Service/Office Assistant
Brooks Home Improvement
08.2014 - 06.2015
Office Manager
The Hunt Law Firm
09.2013 - 05.2014
Dining Room Assistant
Chili’s Bar and Grill
01.2010 - 01.2012
High School Diploma - Early Childhood Ed.
Josephine Dobbs Clement Early College High School
Associate of Arts - Human Resources Management
Durham Technical Community College
Associate of Arts - Medical Assisting
Durham Technical Community College
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