Healthcare Administration with Claims & Strategy Expertise

Amy Tyus

Greensburg, Pennsylvania

Summary

Amy holds a bachelor’s in health care administration management.

Amy Tyus possesses substantial experience in healthcare administration and strategy development, having worked with Highmark Health to enhance patient education and compliance with healthcare mandates.

Efficiently investigates and manages auto insurance claims, ensuring timely resolution and accurate decisions.

She has hands-on experience in benefits where she marketed insurance products and navigated regulatory requirements.

Throughout her career, she has demonstrated a strong commitment to customer service, providing timely updates and ensuring customer satisfaction in both insurance and healthcare settings.

Her roles have involved working closely with internal teams and external partners, leading projects, and enhancing processes to improve operational efficiency and employee engagement.

Education

B.S. in Health Care Administration Management from Slippery Rock University December 2019

Certifications

Resident Producer License: Accident, Health, Life, and Fixed Annuity

LUMA Institute Human-Centered Design Certified

Professional Experience

Progressive Insurance Oct 2023 – present

Claims Generalist Trainee

Investigate liability for auto accidents by reviewing all evidence and make accurate decisions

Provide excellent customer service by responding timely to calls, texts, and emails within a day of receiving

Manage workflow in a timely manner by prioritizing claims and working claims to execution in a timely manner

Work through daily inventory of 4-5 new claims a day and work claims to resolution within a week of assignment

Monitor claim progress and keep customer up to date every couple day

Monitor workload ensuring completing deliverables on time working claims to resolution

Highmark Inc July 2022 – July 2023

Senior Strategy Development Analyst

Enhanced various processes by working with technology partners and department leadership to make reporting structures more efficient

Guided employee engagement efforts to ensure employees feel connected outside of their daily roles

Highmark Health June 2020 – July 2022

Leadership Acceleration Program Associate

Forbes Hospital – AHN

Engaged with Senior Leadership at Forbes Hospital and The Wellness Network to implement patient education channels across the hospital on inpatient units

Ensured hospital staff were compliant with the CMS Vaccine Mandate by working with managers across the hospital to ensure staff were educated and compliant with the mandate

Social Determinants of Health - Highmark Health

Partnered with internal and external teams to identify and build relationships with Community Benefit Organizations (CBO) to increase patient access to healthcare in our communities

Connected with CBOs that align with Highmark Health’s overall SDOH Strategy to gain an understanding of their service models

Provider Intake & Delivery - HMHS

Escalated errors of high priority so they were resolved in a timely manner to increase customer satisfaction

Gained skills working in the following applications: ClearQuest, Oracle, Service Manager, and SharePoint through running daily reports that highlighted key statuses to ensure projects were successful

Federal Markets Medicare Advantage Retention & Satisfaction Team- Highmark Inc.

Led presentations for Medicare Advantage members during open enrolment, explaining changes to their plan for the next year

Created newsletters, quick polls, and share backs for the Health Advisory Board and used the results to determine how members used their benefits at the start of the pandemic

Aflac May 2019 – Aug 2019

Benefits Consultant Intern

Marketed to owners and employees of companies to discuss Aflac’s products

Learned how to abide by the laws and regulations of insurance through attaining a producer’s license and completing Aflac’s flight school training

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