Tanisha Mausehund
@tanishamausehund
Customer service and claims specialist resolving complex medical eligibility and disputes for members and carriers.
United StatesWhat I'm looking for
I’ve handled medical claims processing and customer resolution at United Health Group, stepping in as a Tier 2 claims specialist to help members and Tier 1 reps verify how claims were processed. I’ve also run conference calls with providers, nurses, and resources to resolve issues related to claims, scheduling, and eligibility.
Most recently, I’m on Progressive Insurance Group’s Customer Preservation Team, generating online quotes, completing onboarding enrollments, and creating cases for further investigative purposes. I’ve been recognized by Underwriting for assisting with a fraudulent matter, and by my supervisor with a Star award.
Experience
Work history, roles, and key accomplishments
Assisted prospective customers with generating online quotes for auto and special lines products and completed enrollments for onboarding new customers. Promoted to Service Specialist Consultant in October 2023.
Customer Service Representative I
Empyrean Benefit Solutions
Sep 2021 - Sep 2022 (1 year)
Assisted client groups with New Hire/Newly Eligible and Annual/Open Enrollments, verified eligibility for medical, dental, and vision coverage, and managed client accounts.
Assisted members and Tier 1 reps with claim processing verification, performed conference calls with providers and nurses, and researched complex claims issues.
Assisted members with healthcare plan payments and navigation of myuhc.com, handled first call resolution for benefits, eligibility, claims, and pharmacy inquiries.
Education
Degrees, certifications, and relevant coursework
Sanford Brown College
Medical Assistant Certification, Medical Assisting
2011 - 2012
Completed Medical Assistant Certification program.
Elsik High School
High School Diploma, General Studies
2006 - 2010
Earned High School Diploma.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Job categories
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