Tyler Moore
Blue Island
Summary
Professional and knowledgeable Receptionist and Manager versed in administrative support and customer service. Effective leader who excels at streamlining operations and promotional organization efficiency. Offering hardworking mentality and history of success with computer monitoring and networking. Highly committed to ensuring quality of services.
Experienced health insurance professional with strong background in claims processing, medical coding, and policy interpretation. Adept at analyzing complex cases, ensuring compliance with regulations, and delivering accurate results. Collaborative team player with focus on achieving outcomes and adapting to changing needs. Skilled in communication, problem-solving, and maintaining high standards of accuracy and efficiency.
Experienced with troubleshooting technical issues to provide effective resolutions. Utilizes strong customer service skills to ensure client satisfaction and loyalty. Knowledge of various software and hardware systems to efficiently diagnose and solve problems.
Overview
8
8
years of professional experience
Work History
Health Insurance Claims Adjudicator
Health Core
08.2024 - 06.2025
- Supported growth in business revenue by maintaining an exceptional standard of accuracy in the adjudication process.
- Improved customer satisfaction levels by providing clear communication and prompt resolution of claim inquiries.
- Contributed to departmental success by proactively identifying process inefficiencies and recommending solutions for improvement.
- Maintained compliance with industry regulations and company policies while adjudicating health insurance claims.
- Developed comprehensive understanding of medical terminology, coding systems, and billing procedures for accurate claim processing.
Medical Receptionist
Rush Hospital
01.2024 - 08.2024
- Coordinated patient scheduling, check-in, check-out and payments for billing.
- Checked patient insurance, demographic, and health history to keep information current.
- Helped patients complete necessary medical forms and documentation.
- Maintained strict confidentiality of patient information, adhering to HIPAA regulations and medical office policies.
- Adhered to strict HIPAA guidelines to protect patient privacy.
- Managed high call volumes, directing calls to appropriate departments while maintaining a polite and professional demeanor.
Health Insurance Advisor
One Digital
05.2021 - 12.2023
- Enhanced customer satisfaction by providing accurate and timely information on health insurance policies and benefits.
- Achieved consistent high levels of customer satisfaction through empathetic listening and problem-solving skills when addressing concerns or disputes.
- Provided ongoing support to clients throughout their policy tenure, addressing any concerns or changes in coverage requirements promptly and professionally.
- Increased overall efficiency by streamlining administrative processes related to filing claims paperwork and managing databases containing vital client information.
- Exceeded company-set sales targets regularly through diligent follow-ups with prospects as well as upselling and cross-selling techniques to existing clients.
- Resolved client inquiries efficiently through clear communication, resulting in improved customer relationships and trust.
Receptionist Telephone Operator
Stroger Hospital
04.2019 - 08.2020
- Coordinated travel accommodations for staff and out-of-town visitors, including vouchers, agendas and transportation.
- Monitored premises, screened visitors, updated logs and issued passes to maintain security.
- Directed incoming calls to internal personnel and departments, routing to best-qualified entity to respond to callers' needs.
- Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
- Confirmed appointments, communicated with clients, and updated client records.
- Answered phone promptly and directed incoming calls to correct offices.
- Kept reception area clean and neat to give visitors positive first impression.
- Streamlined front desk operations for increased efficiency by effectively managing phone calls, emails, and walk-in clients.
Manager
Chipotle
01.2018 - 12.2018
- Kept orderly and accurate accounting records by monitoring sales documentation.
- Maintained clean, adequately stocked and organized restaurant by streamlining daily operations and introducing new procedures.
- Boosted team member productivity by enhancing performance monitoring and instituting motivational approaches.
- Cleaned counters, food preparation areas and equipment with sanitizing spray to prevent cross-contamination from raw meat and other items.
Stocker/Cashier
Walmart
02.2017 - 12.2017
- Prepared merchandise for transfer to shelves by removing packing materials and applying identifying codes, such as price or inventory control numbers.
- Maintained well-organized restocking areas to avoid blocking aisles or creating safety hazards.
- Helped customers complete purchases, locate items and join reward programs to promote loyalty, satisfaction and sales numbers.
- Processed POS transactions, including checks, cash and credit card purchases or refunds.
Education
Computer Networking
Western Illinois University
Macomb, ILComputer Networking
Northern Illinois University
Dekalb, IL05.2020
Skills
- Mac systems
- Expert in disaster recovery
- Interpersonal and written communication
- Data quality assurance processes
- HIPAA compliance
- Claims analysis
- Detailed claims analysis
- Telephone etiquette
- Time management
- Technical troubleshooting
- Remote support
- Product troubleshooting
Timeline
Health Insurance Claims Adjudicator
Health Core
08.2024 - 06.2025
Medical Receptionist
Rush Hospital
01.2024 - 08.2024
Health Insurance Advisor
One Digital
05.2021 - 12.2023
Receptionist Telephone Operator
Stroger Hospital
04.2019 - 08.2020
Manager
Chipotle
01.2018 - 12.2018
Stocker/Cashier
Walmart
02.2017 - 12.2017
Computer Networking
Western Illinois University
Computer Networking
Northern Illinois University
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