Tiara Adams
Waldorf
Summary
Experienced with evaluating insurance claims to ensure compliance with policies and regulations. Utilizes strong analytical skills to identify discrepancies and facilitate accurate resolutions. Track record of maintaining detailed records and providing exceptional customer service.
Overview
7
7
years of professional experience
Work History
Enrollment Technician
CRP, Inc.
05.2025 - Current
- Support provider enrollment processes through DHCF, ensuring accurate application completion and compliance
- Facilitated provider enrollment processes through DHCF, ensuring accurate application completion and regulatory compliance
- Performed secure password resets and account access support while maintaining HIPAA and data privacy standards.
- Recorded all interactions in CRM systems (Genesys/CRP) with precision to maintain data integrity
- Directed calls to appropriate pharmacy or clinical staff based on urgency and patient requirements
- Maintain compliance with healthcare regulations and internal quality standards
- Trained new staff on provider enrollment procedures and system navigation.
- Utilized electronic health record systems to maintain accurate provider information.
- Monitored changes in regulations impacting provider enrollment, ensuring timely adaptations to processes.
Call Center Helpline Specialist
The Midtown Group FEMA
Remote
10.2024 - 05.2025
- Resolved complex issues while ensuring a professional and empathetic customer experience
- Managed high call volumes while maintaining customer satisfaction and adherence to service protocols.
- Followed strict scripts, workflows, and compliance standards
- Responded to inquiries regarding disaster assistance programs, ensuring accurate information delivery.
- Utilized CRM software to document interactions, track issues, and improve response times.
Enrollment Data Entry Clerk
CareFirst (Elite Technical Staffing)
Remote
09.2023 - 06.2024
- Facilitated patient enrollment processes, ensuring accurate data collection and documentation compliance.
- Managed electronic health record systems to maintain up-to-date patient information and enhance workflow efficiency.
- Conducted audits of billing records to identify errors and implement corrective actions promptly.
- Enhanced claims processing accuracy, rigorously verifying patient eligibility and benefit coverage.
- Assisted patients with insurance claims, facilitating smooth transactions and proper coverage.
Member Service Representative
Spectra Credit Union
05.2022 - 09.2023
- Assisted members with account inquiries, transactions, and issue resolution, enhancing member satisfaction in a high-volume environment
- Performed secure password resets and account access support, ensuring accurate identity verification and maintaining account security
- Performed secure password resets and account access support, ensuring proper identity verification
- Processed customer transactions efficiently, ensuring accuracy and compliance with banking policies.
- Assisted in fraud prevention efforts by closely monitoring customer accounts and reporting suspicious activity as required.
- Assisted members with loan applications, providing guidance on eligibility and documentation requirements.
Member Service Representative
Sam's Club
Waldorf, MD
11.2019 - 09.2023
- Assisted with training Member Frontline Service associates on company processes and procedures teaching new technology and tool functionality delivering new program rollout training and providing continuous learning and process improvement opportunities
- Greeted and assisted 200+ customers daily, providing fast, accurate, and friendly service regarding product inquiries, refunds, and store directions.
- De-escalated escalated customer complaints and solved service issues to maintain high customer satisfaction scores.
Education
Diploma -
St. Charles High School
Skills
- Provider Enrollment (DHCF)
- Eligibility verification
- Account management
- High-Volume Call Handling
- Patient & Provider Support
- Call escalation
- EHR & CRM systems
- HIPAA compliance
- Account support
- Data accuracy
- Microsoft Office (Word, Excel, Outlook)
- Problem solving
Timeline
Enrollment Technician
CRP, Inc.
05.2025 - Current
Call Center Helpline Specialist
The Midtown Group FEMA
10.2024 - 05.2025
Enrollment Data Entry Clerk
CareFirst (Elite Technical Staffing)
09.2023 - 06.2024
Member Service Representative
Spectra Credit Union
05.2022 - 09.2023
Member Service Representative
Sam's Club
11.2019 - 09.2023
Diploma -
St. Charles High School