Tyesha User
@tyeshauser
Experienced healthcare support specialist focused on Medicare, claims resolution, and compliant member services.
What I'm looking for
I am an experienced healthcare and insurance support specialist with over nine years working in regulated environments supporting members, providers, and payers.
Throughout my career I have handled high-volume call center communication, Medicare Advantage inquiries, claims and eligibility investigations, and enrollment changes while maintaining CMS and HIPAA compliance.
I am proficient with CRM and member tracking systems, Microsoft Office (Word, Excel, Outlook), and internal documentation tools; I consistently document outcomes and support cross-departmental coordination to resolve issues promptly.
I am recognized for professionalism, empathy, and a commitment to accurate, timely service delivery and have contributed to training materials and process improvements to strengthen team performance.
Experience
Work history, roles, and key accomplishments
Healthcare Call Center Specialist
Bayview Health Partners
Jan 2022 - Jun 2025 (3 years 5 months)
Responded to Medicare-related member and provider inquiries, researched cases in internal systems, and resolved eligibility, claims, and enrollment issues while maintaining CMS compliance and timely follow-up.
Health Insurance Service Representative
FirstPoint Health Services
Jan 2018 - Dec 2021 (3 years 11 months)
Handled high-volume contact center inquiries for Medicare Advantage plans, processed enrollment changes and verifications, and documented outcomes to improve tracking and team processes.
Claims & Eligibility Support Specialist
Riverview Medical Center
Jan 2014 - Dec 2017 (3 years 11 months)
Investigated eligibility discrepancies and service denials, updated patient records in HIPAA-compliant systems, and collaborated with providers and compliance teams to resolve coverage issues.
Education
Degrees, certifications, and relevant coursework
Dawn Career Institute
Certificate, Healthcare Administration
Completed the Healthcare Administration program focusing on administrative processes, documentation, and healthcare operations.
Tech stack
Software and tools used professionally
Availability
Location
Authorized to work in
Job categories
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