Summary
Overview
Work History
Education
Skills
COMMUNICATION
LEADERSHIP
Timeline
Generic
DALAYJA T. WILLIAMS

DALAYJA T. WILLIAMS

Maple Heights

Summary

To obtain employment that will allow me to utilize and sharpen my skills obtained learning to import data efficiently and promptly. Analyze and sort out data into database and creating backup. Utilize my analytical skills and ensuring accuracy in timely manner. Also to provide appropriate etiquette when communicating within the job, team members and maintain a positive attitude and growth.

Professional claims specialist with strong record in handling and resolving complex claims efficiently. Adept at analyzing data, identifying discrepancies, and providing solutions that drive positive outcomes. Effective team collaborator with focus on achieving results and adapting to evolving requirements. Skilled in negotiation, customer service, and regulatory compliance, consistently ensuring accuracy and fairness.

Overview

10
10
years of professional experience

Work History

Claims Specialist III- Remote

Centene
04.2022 - 03.2025
  • Subject but not limited to, analyze authorizations provided through submissions to verify accuracy, Verify and review insurance coverage for submitted claims, Confirm accuracy of medical coding
  • Checking the accuracy of data, resolving discrepancies in information and obtaining further data and information as needed
  • Multitask and manage many systems including Microsoft Outlook and teams to communicate with team
  • Meeting monthly goals

Shift Lead/Customer Service- Remote

Sameday Health
01.2019 - 03.2022
  • Subject but not limited to, resolving to customer inquiries via email or live chat, assisting team members promptly responding to issues in the Teams chat
  • Promptly resolving customer's delay in Covid results in time for international travel
  • Deescalating customers' concerns and resolving them promptly submitting call logs and ensuring the accuracy of data
  • Uploading resource information in SharePoint for customer service representative

Patient Service Specialist

Cleveland Clinic-Marymount Emergency Services
08.2015 - 12.2018
  • Outpatient, ER, inpatient psych/behavioral health, Scheduled transfusions, surgeries and cardiac rehab, Claim processing, and cross trained to staff and supervise departments at any facility
  • All above and including OP lab, admitting office, cashier's office
  • Maintained release of medical records to appropriate facilities or physician offices

Education

High School Diploma -

Garfield Heights High School
Garfield Heights, OH
06-2011

Nursing Assistant Certificate - Nursing Assistant

Med-Cert
Maple Heights, OH
04-2013

Bachelor of Science -

Chamberlain University College of Nursing
08-2027

Skills

  • Typing speed 65 WPM, Communication, Extremely organized, Works well independently, Quick Problem Solving, Patience, Empathy, Integrity, Time Management, Active Listening, Computer Literacy, Teamwork, Microsoft, Excel, Microsoft Teams, Microsoft Word, Microsoft Spread Sheet, EPIC, SharePoint, Zendesk
  • Claims
  • Claims processing
  • Claims investigation
  • Verbal communication
  • Organizing and prioritizing work
  • Attention to detail
  • Prior authorization processing

COMMUNICATION

I am a very approachable and easy to get along with others. I am a team player and work well independently. I also like to take the initiative when opportunity presents itself. Self-motivated and goal oriented. I also am an excellent communicator. I am natural leader often look to frow into leadership roles. I good a problem solving and taking initiative to do so.

LEADERSHIP

Extremely organized and prompt to delegating and completing tasks and projects.

Timeline

Claims Specialist III- Remote

Centene
04.2022 - 03.2025

Shift Lead/Customer Service- Remote

Sameday Health
01.2019 - 03.2022

Patient Service Specialist

Cleveland Clinic-Marymount Emergency Services
08.2015 - 12.2018

High School Diploma -

Garfield Heights High School

Nursing Assistant Certificate - Nursing Assistant

Med-Cert

Bachelor of Science -

Chamberlain University College of Nursing
DALAYJA T. WILLIAMS