Tyaja Wade
CohereHealth
Dallas
9
years of professional experience
Motivated and dependable health care professional with over 5 years of experience in administrative support, utilization management, and client services within fast-paced, compliance-driven environments. Skilled in medical terminology, data entry, prior authorization, and customer service with a strong passion for improving access to care. Committed to supporting healthcare teams in delivering outcomes-driven, patient-focused service while maintaining confidentiality and regulatory standards.
Work History
Member / Provider Services Representative
1 Year 1 Month- Facilitated communication between healthcare providers and members to resolve inquiries efficiently.
- Coordinated provider enrollment processes, ensuring compliance with regulatory standards.
- Conducted training sessions for new staff on systems and procedures to enhance service delivery.
- Streamlined workflows by implementing best practices in provider support and issue resolution.
- Verify insurance eligibility and coordinate prior authorizations.
- Communicate with providers regarding patient care coordination.
- Maintain strict HIPAA compliance in high-volume healthcare
Skills - Verified insurance eligibility and scheduled appointments.
environment. - Collaborated with healthcare providers to resolve claims and billing
inquiries promptly.
- Facilitated communication between members and provider networks,
enhancing service delivery.
Intake Specialist/PeertoPeer MD Room Support Lead
3 Years 1 Month- Process incoming requests for prior and ongoing authorizations from providers and facilities.
- Interact with customers/ healthcare providers via inbound calls, outbound calls, emails, and other communication platforms.
- Collect and gather all necessary information for clinical review.
- Maintain accurate medical and authorization data records in alignment with HIPAA and Medicare guidelines.
- Troubleshoot provider portal issues and coordinate appointments for clinical reviews.
- Act as a Room Support Lead, offering daily operational direction and handling case escalation.
- As a Room Support, it is the responsibility to ensure that the Peer to Peer team is provided with steady work and support when handling emails.
- Room Supports are to remind team members to be in the right Aux code when switching them between functions.
- Room Supports are to be available for any questions in the room.
- Cross-trained with various positions within the company.
Front Desk Receptionist
8 Months- Verified membership eligibility and processed payments using POS systems.
- Managed front-desk operations including appointment scheduling and high-volume visitor check-ins.
- Processed daily reports and tracked member issues and follow-ups for resolution.
- Maintained daily financial records and confirmed customer information to support accurate billing.
Customer Service Specialist
1 Year 7 Months- Processed patient records and verified insurance eligibility and coverage, supporting accurate treatment planning.
- Communicated with patients and providers regarding billing, appointment scheduling, and authorization needs.
- Demonstrated working knowledge of CPT, ICD, and healthcare documentation to support quality service delivery.
- Entered and updated patient data accurately into electronic systems while ensuring HIPAA compliance.
- Answered high call volume and assisted with patient inquiries and service coordination.
Education
Associate of Science - Billing & coding
Associate of Science - Ultrasound Tech
High School
Skills
Prior authorization processing
Medical terminology
Healthcare data entry
Provider communication
Electronic Health Record (EHR) systems
Claims and insurance processing knowledge
Multitasking and organization
HIPAA compliance
Strong verbal and written communication
Microsoft Office (Word
Excel
PowerPoint
Outlook)
LANGUAGES
English
Timeline
Member / Provider Services Representative
AmeriHealth Caritas
01.2025 - 02.2026Read More
Intake Specialist/PeertoPeer MD Room Support Lead
CohereHealth
05.2023 - CurrentRead More
Front Desk Receptionist
The Loft Athletic Club
08.2018 - 04.2019Read More
Customer Service Specialist
Kool Smiles
01.2017 - 08.2018Read More
Mallard Creek High School
High School
Read More
Cambridge Institute of Allied Health and Technology
Associate of Science from Ultrasound Tech
Read More
Ultimate Medical Academy
Associate of Science from Billing & coding
Read More