Tamishia Clayborn Email & Phone Number

HealthCompare an Allstate company Dallas, TX (Hybrid)Leads a team of 10 to 20 agents. Provided guidance, coaching, and development of Medicare sales agents at beginner and advanced levels (BAT, BA, SBA). Strategic sales development of agents into top agent status, achieving leaders club, and helped them promote up to the next agent level/status. Consistently maintained 2 to 6 agents in leaders club (top 1% of the company) from my team alone each month. Created original sales scripts, techniques, call flow/structure, and closing tactics while teaching agents the skills/techniques to achieve success. Maintained agents understanding and adherence to CMS guidelines/QA compliance. Created/developed and trained agents on the sales process, call flow, call scripting, and other resources for agents to use and develop their sales skills. Responsible for supervising, engaging employees, and recruiting/interviewing new sales staff. Leader in developing agent’s performance expectations to consistently exceed monthly sales goals. Managed agents workflow, adherence, sales goals, and understanding of their responsibilities. - Consistently Achieved Leader of the year award in 2021, 2022, 2023- Strategic sales development and call structure creation, Strategic sales coaching/strategies training to close the sale, script development and implementation, Employee training and development, Structured overcoming objection coaching Strategic marketing, self-branding, and competitive knowledge of Medicare sales, MAPD, Medigap, PDP, Dental, Vision Product knowledge; CMS compliance, SEP/AEP/OEP-Familiar with Workday, AgentCubed, Interaction Desktop, TEAMS, KRONOS, and other proprietary software.

Consistently remained in the top 1% of the company sales agents and a top sales performer. Managed daily customer relationship development and establishment through direct tele-sales outbound and inbound campaign contact to warm/cold leads. Managed Active and New accounts, sales quotas and ratios, and Medicare sales presentations through the tele-sales process. Leader in performance expectations, consistently exceeded monthly sales goals and remained in the top 1% of the Medicare sales department. Assisted with training and grooming sales agents to increase their sales/goals to obtain immediate results. MAPD, Medigap, PDP, Dental, Vision Product knowledge; CMS compliance and SEP/AEP/OEP knowledge-Achieved/Received the highest conversions award for 2018 and quarterly leaders club for the 2018/2019 .-Established development of new client relationships through customer satisfaction analysis and Account Management/Sales-Maintained accurate records of new clientele interest and sales ratios per appointment

Consistently remained in the top 1% of the company sales and a top sales performer for four years. Actively participated in three trips that were given to the top 1% of Medicare Sales Representatives. Managed daily customer relationship development and establishment through direct tele-sales outbound and inbound campaign contact to warm/cold leads. Managed Active and New accounts, sales quotas and ratios, and Medicare sales presentations through tele-sales/telecommunications. Lead performance expectations, consistently exceeded monthly sales goals and remained in the top 1% of the Medicare sales department. Managed, trained, and groomed sales agents to increase their sales/goals to obtain immediate results. Managed over 50 agents in daily tasks, corporate morale, sales goals, and tools to gain increased results. MAPD, Medigap, PDP, Dental, Vision Product knowledge; CMS compliance and SEP/AEP/OEP knowledge-Achieved/Received the Top Agent Reward for sales performance in 2015, 2016, 2017 and was the No. 1 agent in the first quarter of 2018-Established development of new client relationships through customer satisfaction analysis and Account Management/Sales-Maintained accurate records of new clientele interest and sales ratios per appointment-Maintained top tier sales quota while managing and grooming other agents to achieve the same/similar results.

Managed daily customer relationship development and establishment through direct contact to warm/cold leads. Managed Active and New accounts, sales quotas and ratios, and direct face to face presentations through direct business to business sales. Lead performance expectations through increasing client base by over 80% of the original client volume. Maintained general office relations and trained staff in customer service, new customer relationship development techniques, and direct sales techniques.-Maintained customer service relationships and response to product inquiry/review-Established development of new client relationships through customer satisfaction analysis and Account Management-Maintained accurate records of new clientele interest and sales ratios per appointment

Managed consistent written and verbal communication between clients, members, and corporate associates regarding implanting the pharmacy plan benefits purchased by the client. Managed the implementation process of 340B Affordable Medication Programs through project management from the initiation of the agreement to the launch of the benefit/product purchased by the client. Maintain detailed records and developed client communication throughout the implementation process. Maintained reporting and records for daily accounts payable and accounts receivable transactions between the client and contracted pharmacies. Lead cost reduction and process improvement projects resulting in improvement in department operations. -Analytical and payment accuracy review of client/member files, forms, pharmacy benefit claims-Pharmacy benefit coding/claim form knowledge, ICD-9/ HCPC/CPT coding, UB92/UB04/HCFA forms

Woodland Hills, California, Us

Maintained daily accounts receivable and accounts payable review of disputed medical claims. Managed consistent written and verbal communication between members, providers, and corporate associates regarding case file review and final determination of medical benefits available through the schedule of benefit/health plan. Lead cost reduction and process improvement projects resulting in improvement in department operations. Processed a daily count of over 100 PPO/HMO claims as a claim examiner. Reviewed and verified claim accuracy through cross referencing the claim CPT codes with the policy and procedures to determine the cost associated with the claim payment. Evaluated policies and procedures based on the third party claims payment. Adjusted claims and evaluated the account payable or account receivables of medical claims based on the contract agreement of the provider. Reviewed and evaluated provider contract agreements and processed claims according to the agreement percentage rate indicated in the contract for the claims submitted. Recouped claims that were deemed to be over paid after the claims adjustment evaluation. Redeemed recouped funding through claims collections. Evaluated and reported suspicious and fraudulent claims based on the insurance regulation laws and requirements. -Analytical and payment accuracy review of medical files, forms, claims-Medical coding/claim form knowledge, ICD-9 coding, HCPC/CPT coding, UB92/UB04/HCFA forms -Product knowledge of PPO, HMO, IFP, FLEXNET, MEDICARE, MEDICAL, FIRST HEALTH, HOME HEALTH, CSP, HEMO/CHEMO, SPECIALTY PRODUCTS

Sacramento, California, Us

Managed daily overview of medical insurance claim submissions of workers compensation cases through review of medical necessity of services rendered. Determined financial responsibility and accounts receivable/payable of services approved. Manual data processing and accuracy review of medical claims.-Analytical and payment accuracy review of medical files, forms, claims-Medical data accuracy confirmation of ICD-9 coding, HCPC/CPT coding, UB92/UB04/HCFA forms

Managed private field workers compensation claims investigation focused on direct communication with claimants and insured clients. Maintained communication related to case developments and discoveries determined through the investigation process. Lead stake-out/sub-rosa on site investigation of claimants and recorded video documentation of daily activity. -Determined medical necessity of injuries through face to face and telephone recorded statements-Wrote detailed reports of investigation overview/ field video documentation -Managed high volume case load and consistency (Case volume included traveling Northern CA region)

Newark, New Jersey, Us

Managed day to day customer relationships specific to property and casualty losses and claim submission review. Performed extensive explanation of coverage of policy allowance/limitation. Immediate extensive response to policy inquiry and financial responsibility. Maintained case review and completion of property loss assessments. Lead team goal and accountability score for two months. -Managed auto and property claim loss assessment with a case load of 250 or more-Determined financial responsibility and percentage of liability based on recorded statement

Newark, New Jersey, Us

Managed daily customer relationship development and establishment through direct contact to warm/cold leads. Lead performance expectations through increasing client base by over 80% of the original client volume. Maintained general office relations and trained staff in customer service and new customer relationship development techniques.-Maintained customer service relationships and response to product inquiry/review-Established development of new client relationships through customer satisfaction analysis-Maintained accurate records of new clientele interest and sales ratios per appointment

Conctacted students and staff members regarding events the Cross Cultural Center sponsored. Created press releases to distribute to local news papers. Participated in a panel that approved the applications submitted by students for grants that were approved from a $10,000 budget.

Bachelor Of Arts - Ba, English Language And Literature, General

Mba, Business Administration

B.A., African And African-American Studies

Bachelor Of Arts - Ba, African-American/Black Studies

Bachelor Of Arts - Ba, English Language And Literature/Letters

Master Of Business Administration - Mba, Business Administration And Management, General