Trisha Tannis

Healthcare Customer Service Specialist and Appeals/Grievances professional with extensive experience supporting Medicare Advantage members through complex case research, compliance, and member advocacy. Expert at navigating claims, benefits verification, prior authorizations, eligibility, and specialized pharmacy benefits (Optum Rx) within high-volume call center environments. Proficient in specialized managed care platforms including Salesforce, HRP, and Guiding Care.

Proven track record of de-escalating challenging interactions with empathy and precision, ensuring strict adherence to CMS regulations and confidentiality standards while coordinating across cross-functional healthcare networks. and pharmacies.

Customer Care Advocate / Member Support — Medicare Advantage - BLUE CROSS BLUE SHIELD - REMOTE

(2023 - 2026-09)

• Provide customer service and member support to Medicare Advantage members regarding claims, benefits, eligibility, enrollment, pharmacy benefits, coverage, and plan-related questions.
• Research and resolve complex member issues by reviewing account information, benefits, coverage, and available resources and communicating appropriate next steps.
• Utilize Salesforce, HRP, and Guiding Care to research member information, verify benefits, document interactions, and support issue resolution.
• Explain deductibles, copayments, coinsurance, coverage, plan benefits, eligibility, enrollment requirements, and out-of-pocket costs in clear, easy-to-understand language.
• Collaborate with Optum Care, Optum Rx, internal departments, and local pharmacies to resolve prior authorization, prescription access, pharmacy benefit, vacation override, and medication-related concerns.
• Investigate complex concerns and coordinate with healthcare partners and internal departments to identify appropriate resolutions and facilitate member access to services and medications.
• De-escalate challenging member interactions using empathy, active listening, patience, professional communication, and problem-solving skills.
• Accurately document member interactions and research findings while following established procedures, compliance requirements, and confidentiality standards.

Designated Broker — Part-Time - OWNIT REALTY

(2019)

• Serve as primary customer contact, resolving questions, concerns, and transaction-related issues while maintaining a professional customer experience.
• Review and audit documentation for accuracy, completeness, compliance, and legal requirements.
• Research complex issues and communicate solutions clearly to customers and agents.
• Train and support agents regarding policies, procedures, compliance, documentation, contracts, and customer service standards.
• Maintain confidentiality of sensitive customer records and provide coaching and dispute resolution as needed.

Customer Service Specialist - SAN DIEGO COUNTY CREDIT UNION

(2017 - 2019)

• Managed 75–100 inbound calls daily in a high-volume call center, providing accurate, professional, and efficient member service.
• Used active listening, needs assessment, research, and problem-solving to resolve member concerns and service issues.
• Resolved inquiries involving account transfers, stop payments, funds availability, ATM/debit cards, check verification, and general account services.
• Investigated disputed transactions and compromised credit/debit cards while following security, compliance, and internal control procedures.
• Opened accounts, processed ACH payments, prepared cashier's checks, and provided technical support for online banking services.
• Maintained accurate documentation and protected confidential financial and personal information.

Designated Broker - AMERICAN DREAM REALTY

(2003 - 2019)

• Served as primary customer contact, researching and resolving complex customer questions and concerns through effective communication and problem-solving.
• Recruited, trained, mentored, and supervised staff while maintaining high standards for customer service, documentation, and regulatory compliance.
• Reviewed contracts and documentation for accuracy, completeness, compliance, and legal requirements.
• Conducted staff training and performance evaluations, provided coaching, and facilitated dispute resolution.
• Delivered 90 hours of pre-licensing instruction to aspiring real estate salespersons and broker candidates.
• Received Multimillion-Dollar Producer recognition in 2005, Million-Dollar Producer recognition in 2006, and multiple Top Producer awards.

Part-Time - NOTARY PUBLIC / LOAN SIGNING AGENT

(2015)

• Provide professional customer service while handling sensitive personal, financial, and legal documentation.
• Verify identities and signatures, administer oaths, authenticate documents, and complete affidavits accurately.
• Coordinate appointments and communicate with customers and lending partners to ensure timely service.
• Maintain strict confidentiality and accuracy when handling sensitive personal and financial information.

Real Estate Salesperson and Broker Education - ARIZONA SCHOOL OF BUSINESS AND REAL ESTATE (2003 - 2007)

High School Diploma - CHUGIAK HIGH SCHOOL