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Tyiesha JordanTJ
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Tyiesha Jordan

@tyieshajordan

I resolve healthcare claims denials and recover reimbursement across complex revenue cycle accounts.

United States
Message

At Palmetto Infusion, I support accurate claim submission, payment processing, reimbursement, and month-end reconciliation while resolving denials, payment discrepancies, and unapplied cash.

Previously, I processed commercial, Medicare, and Medicaid claims at Alabama Pain Physicians, prepared appeals, verified eligibility, assigned ICD-10 codes, and analyzed accounts receivable reports for resolution opportunities.

My experience also includes claims adjudication at Blue Cross and Blue Shield of Alabama and hospital denial resolution at Guidehouse Healthcare. I investigate underpayments, calculate expected reimbursement, correct denial codes, and document root-cause resolutions.

I've worked directly with providers, members, payers, and patients in high-volume environments, including handling 60–100 inbound calls daily. I bring more than seven years of medical billing, claims processing, insurance follow-up, and customer service experience.

Experience

Work history, roles, and key accomplishments

BA

Claims Specialist

Blue Cross and Blue Shield of Alabama

Jan 2023 - Jul 2023 (6 months)

Reviewed insurance claims and supporting documentation to ensure completeness and compliance with policy requirements. Investigated claim issues and obtained additional information necessary for claim adjudication and payment determination.

GH

Denial Specialist

Guidehouse Healthcare

Oct 2021 - Jan 2023 (1 year 3 months)

Managed denial resolution activities for hospital accounts receivable portfolios, ensuring timely follow-up and reimbursement recovery. Researched and resolved billing, payment, and claim issues through collaboration with payers and healthcare providers.

BA

Customer Service Associate

Blue Cross Blue Shield of Alabama

Apr 2019 - Oct 2021 (2 years 6 months)

Handled 60–100 inbound calls daily from members and providers regarding claims, benefits, and coverage questions. Reviewed claims and explained processing outcomes while assisting with claim reconsiderations and reprocessing requests.

DS

Customer Service Representative

DST Health Solutions

Oct 2017 - Mar 2019 (1 year 5 months)

Responded to customer inquiries regarding healthcare accounts and services. Updated account information and maintained accurate customer records.

Education

Degrees, certifications, and relevant coursework

Northeast Texas Community College logoNC

Northeast Texas Community College

Associate of Applied Science, Applied Science

2026 -

Pursuing an Associate of Applied Science degree, with an expected completion in 2026.

WS

Woodlawn High School

High School Diploma, General Studies

Completed high school education in May 2011.

Tech stack

Software and tools used professionally

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