Akira Jones
Summary
Customer experience, claims, and operations professional supporting high-volume remote service teams through accurate issue resolution, account research, and case documentation. Handles complex customer questions, claim discrepancies, and billing concerns while maintaining quality, compliance, and calm communication across multiple systems.
Overview
14
14
years of professional experience
Work History
Customer Service Representative
Spectrum
02.2021 - Current
- Manage 60–70 inbound customer interactions daily across service, billing, equipment, account, and technical-support needs.
- Coordinate technician dispatches, service appointments, and equipment connections while balancing multiple priorities in a fast-paced remote workflow.
- Apply structured troubleshooting, research, and root-cause thinking to identify issues and deliver accurate first-line resolutions.
- Investigate disputed transactions and account concerns, document findings, and use internal systems and resources to support timely resolution.
- Maintain customer-focused communication, de-escalate concerns, and protect accuracy while working across multiple digital platforms.
- Consistently adapt to automated systems, changing workflows, performance expectations, and technology-enabled service processes.
- Remote
Healthcare Representative
Christus Health
11.2019 - 02.2021
- Processed 80–90 medical claims daily while reviewing coverage, deductibles, carrier payments, eligibility, and outstanding balances.
- Performed detailed claim research to identify discrepancies, validate information, and support accurate claim resolution.
- Verified insurance coverage and completed pre-authorizations and precertifications while maintaining attention to detail and compliance requirements.
- Collected and validated patient registration and insurance information, maintaining accurate records across healthcare systems.
- Applied analytical judgment to determine coverage amounts and coordinate payments or reimbursements based on available claim and benefit information.
- Remote
Team Leader
Morley
Saginaw, Michigan
02.2016 - 11.2019
- Coached Morley team members on call handling and service standards.
- Monitored Morley calls for quality, accuracy, and script compliance.
- Resolved customer escalations using Morley service procedures and policies.
- Led Morley contact center agents through daily customer service workflows.
- Reviewed performance reports and shared feedback with Morley agents.
- Documented team issues and communicated updates to Morley leadership.
- Maintained a positive work environment that promoted collaboration between team members.
- Offered training and support to keep team members motivated and working toward objectives.
Insurance Representative
Morley Companies, Inc.
08.2012 - 11.2019
- Managed 50–60 inbound and outbound customer and claimant interactions involving auto claims, policies, billing, and roadside assistance.
- Gathered, organized, and documented accident facts to support liability review, claim decisions, and customer resolution.
- Explained policy coverage, created methods of inspection, and identified potential subrogation opportunities.
- Applied applicable state and federal laws, statutes, and insurance regulations throughout the claims-handling process.
- Delivered high-quality customer support while managing sensitive information, competing priorities, and high-volume workflows.
Education
Cybersecurity And FinTech - College of Technology
Wilmington University
New Castle, DE06-2025
High School Diploma -
Arthur Hill High School
05-2010
Skills
- Remote Customer Experience (CX)
- Digital & Systems Fluency
- Technical Troubleshooting
- Prior Authorization & Eligibility
- High-Volume Queue Management
- Research & Investigation
- Microsoft Office & Digital Tools
- Knowledge-Base Navigation
- Customer Success & Retention
- Claims & Case Management
- Billing & Payment Support
- Data Accuracy & Documentation
- De-escalation & Conflict Resolution
- Process Improvement
- Cross-Functional Communication
- AI-Assisted Workflow Optimization
- Complex Issue Resolution
- Insurance & Benefits Verification
- CRM / Multi-System Navigation
- Root-Cause Analysis
- Quality Assurance & Compliance
- Time Management & Prioritization
Timeline
Customer Service Representative
Spectrum
02.2021 - Current
Healthcare Representative
Christus Health
11.2019 - 02.2021
Team Leader
Morley
02.2016 - 11.2019
Insurance Representative
Morley Companies, Inc.
08.2012 - 11.2019
Cybersecurity And FinTech - College of Technology
Wilmington University
High School Diploma -
Arthur Hill High School