Senior Health Claims & Customer Service Specialist

Tammy Ahlstrom

480-***-**** • ************@******.***

Dedicated Health Services Customer Service Representative with proven success in delivering compassionate, solutions-focused support to patients, providers, and insurance partners. Skilled in resolving complex billing and claims inquiries, and ensuring HIPAA compliance in all communications. Known for excellent attention to detail, building strong relationships, deescalating concerns, and improving the patient experience in fast-paced call center and healthcare environments. Proficient in insurance verification, and cross-team collaboration to streamline service delivery. Committed to making healthcare support clear, respectful, and efficient.

Experience

MAY 2021 – AUGUST 2025

Senior Customer Service Health Services McKesson Phoenix, Arizona

Conducted outbound prior authorization verifications to ensure timely medication approval and patient access.

Managed outbound communications with pharmacies and insurance plans to resolve authorization and coverage issues.

Updated patient and account information accurately in Hubble and Salesforce CRM following each interaction.

Completed special projects, including account verification by coordinating directly with physician offices.

Provided exceptional customer support, promptly addressing inquiries and concerns to enhance satisfaction and trust.

Maintained outstanding Quality Assurance (QA) results, consistently achieving 100% performance scores.

Mentored and trained new employees, facilitating onboarding sessions and product knowledge training to improve service delivery.

Served as a temporary seasonal lead, guiding team operations and ensuring performance goals were met during peak periods.

Resolved issues efficiently by identifying root causes and implementing practical, effective solutions.

Fostered team collaboration by actively engaging with colleagues to achieve shared objectives and optimize workflows.

Communicated effectively with diverse stakeholders, ensuring clarity and professionalism in all interactions.

Supported patients through medication appeal calls, advocating for timely access to prescribed treatments.

Skills

Medical Terminology • Health Insurance Knowledge • Prior Authorizations • HIPAA Compliance • Insurance Verification • Empathy and Compassion • Active Listening • Clear and Professional Communication • Deescalation Techniques • Time Management • Problem Solving • Multitasking in Fast Paced environments • Data Entry Accuracy • CRM Tools • Microsoft Office Suite

Education

1998 -1999

College of Lake County, Il

Data Entry courses

GED

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