Dikesha Clayborn
Forney
Summary
Results-oriented professional with extensive experience, specializing in enrollment processing and customer communication. Demonstrated success in streamlining operations and improving service quality. Strong problem-solving skills and expertise in navigating complex Medicare plans. Proven leadership in driving teams towards operational excellence.
Overview
12
12
years of professional experience
Work History
Pre Enrollment Specialist/ Customer Service Representative
Willis Towers Watson - ExtendHealth
09.2024 - Current
- Assisted participants with enrollment and website navigation.
- Handled inbound and outbound calls for effective communication.
- Provided funding and reimbursement information to ensure clarity.
- Explained differences among various Medicare plans for informed decisions.
- Updated personal information to maintain accurate records.
Claim Adjuster
Blue Cross Blue Shield - Kelly Services
MARSHALL
12.2022 - 12.2023
- Streamlined processing of medical claims to achieve timely resolutions.
- Evaluated and processed medical claims for approval or denial based on established criteria.
- Resolved prompts and locks to enhance operational efficiency.
- Input claim information and payments into company database.
Sales Agent
Advance Staffing S4 Communications
09.2021 - 12.2022
- Handled inbound and outbound calls to address customer inquiries effectively.
- Demonstrated strong telephone communication skills in high-pressure environments.
- Provided exceptional customer service, resolving issues promptly and efficiently.
- Leveraged call center expertise to enhance overall operational performance.
Team Lead
Whataburger
10.2013 - 03.2021
- Customer service
- Demonstrate fiscal responsibility
- Food prep & delivery
- Daily operations
- Ensure quality standards
- Restaurant administration
- Communicate issues with management
- Maintain required certifications
Education
Associate of Science - Criminal Justice
Remington College
Shreveport, LA08-2018
Skills
- Microsoft Office proficiency
- Self-starter
- Management skills
- Problem solving and organization
- Punctuality
- Assertiveness
- Enrollment processing
- Medicare knowledge
- Claim evaluation
- Customer communication
- Team leadership
- Healthcare common procedure coding system HCPCS
Affiliations
Faces of Angels Dallas, TX- Phlebotomist certification (currently enrolled)
- commute to two days a week
- order of draw
- venipuncture and capillary puncture
- properly apply a tourniquet
- identify a patient
Timeline
Pre Enrollment Specialist/ Customer Service Representative
Willis Towers Watson - ExtendHealth
09.2024 - Current
Claim Adjuster
Blue Cross Blue Shield - Kelly Services
12.2022 - 12.2023
Sales Agent
Advance Staffing S4 Communications
09.2021 - 12.2022
Team Lead
Whataburger
10.2013 - 03.2021
Associate of Science - Criminal Justice
Remington College
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