Administrative & Risk Support Specialist
Resume:
Tammy Clayton
Mayfield Heights, Ohio 44124
***********@*******.***
Career Summary:
Administrative Support, Clerical, Customer Service and Receptionist, Functions well-developed organizational skills and a positive team member, adapt very well to new situations and employer changing priorities. Work well under pressured timetables.
Work History:
10/2025 to 05/2026 Paychex Highland Hills, Ohio
Collateral Risk Associate
Responsible for collecting and evaluating data to monitor collateral and manage client risk profiles. This
role involves analyzing payroll registers against purchased invoices to ensure client compliance with
company standards to identify potential fraud, while making informed collateral risk alert decisions
based on the gathered in.
11/2019 to 10/2025 Funding Invoice Specialist
Obtain and saves collateral items (invoice copies, payroll registers, and dillies) from clients. Requests
missing collateral items directly from client. Compare data entered in Factor SQL to actual invoice copies to identify any necessary changes or adjustments. Resolve Discrepancies as needed.
12/2018 to 03/2019 Humana Irving, Texas
UM (Utilization Management) Administration Coordinator I
Perform basic administration/clerical operations and customer support, viewing 200-240 authorizations
to verify if Medicare, Medicaid or Commercial approved and rerouting to appropriate department for further review or to be reworked so that the patient can receive their medication, also updating refill
amount and quantity and daily supply (but not limited to). Create Mirror Authorizations when requested.
06/2018 to 10/2018 RemX Fort Worth, Texas
McKesson Pharmaceutical (Patient Care Coordinator)
Responsible for answering heavy volume of inbound and outbound (50-70) calls to assist patients with
setting up shipments for delivery of their prescriptions, updating demographics and tracking
packages due to delayed shipment. Responsible for sending correspondence to the Replacement
Team to reschedule shipments when medication is lost in the mail, also speaking with health care providers when needed to clarify missing information, NPI and Physicians signatures, patient
date of birth (but not limited to).
06/2015 to 11/2017 Transworld Systems Inc. Valley View, Ohio
Collector Specialist
Responsible for Specialty Accounts, manual dial out to collect for outdated balance due
on accounts for Senior Citizen Facilities and Rehabilitation Centers and Hospitals, also
for Music and Arts Supplies, we must contact 144 accounts daily (but not limited to).
Also request to have accounts transfer to my daily route once payment or promised received.
10/2014 to 04/2015 CVS Caremark Solon, Ohio
Customer Care Representative-Call Center-Med D
Enroll Med D Members in a Prescription Drug Plan and check our drug formulary for eligibility and pricing. Run Test Claims, refill prescriptions, check shipping details and transfer to appropriate department (but not limited to). Call Clinical Department as needed also transfer members to request
prior authorization for medications not on our formulary.
05/2012 to 10/2014 Sedgwick CMS Services Seven Hills, Ohio
Customer Care Professional
Responsible for answering heavy volume of calls, assist customers with coverage details when using
their American Express cards to rent vehicles domestic or international. Assist with manual
adjustments when renting through third parties, (but not limited to) transferring calls to the appropriate
Departments. File claims for insurance coverage, after 48 business hours provide status.
Education:
Secretarial Science Cuyahoga Community College Cleveland, Ohio
High School Diploma John Hay High School Cleveland, Ohio
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