Emily Williams
Dallas,TX
Summary
Benefits professional with strong foundation in verifying and processing claims, ensuring compliance with industry standards. Known for reliability and adaptability, consistently meeting dynamic needs of team. Brings expertise in data management and communication, driving successful outcomes through collaborative efforts.
Overview
4
4
years of professional experience
Work History
Benefits Verification Specialist
CVS
06.2023 - 10.2025
- Assisted in verifying patient eligibility for benefits using internal systems
- Gathered necessary documentation to support benefits verification processes
- Collaborated with healthcare providers to obtain accurate information
- Maintained updated records of patient benefit statuses and communications
- Utilized advanced research skills to investigate specific policy provisions and resolve any ambiguities or conflicts.
- Optimized the use of electronic claims submission systems to expedite claim processing times.
- Reduced errors in benefit verification tasks by conducting thorough audits and rectifying discrepancies.
- Established positive relationships with insurance carriers, streamlining communication channels when clarifying policy details or negotiating terms on behalf of clients.
- Streamlined workflow for benefit verification team by implementing a comprehensive data tracking system.
- Learned compliance regulations related to benefits verification procedures
- Supported team by responding to inquiries regarding coverage and claims
- Provided support during open enrollment periods by answering questions about plan changes, adjustments, or renewals from both existing and prospective clients alike.
- Conducted regular performance evaluations for junior staff members, offering constructive feedback and opportunities for growth within the role.
- Resolved issues and inquiries from plan participants regarding health and welfare benefits and deductions through telephone, email, and in-person interactions.
- Explained benefits to plan participants in easy to understand terms in order to educate each on available options.
Contact Center Representative
United States Mint
08.2021 - 05.2023
- Managed high-volume inbound calls, addressing customer inquiries and concerns efficiently.
- Provided detailed information on products and services, enhancing customer understanding and satisfaction.
- Resolved customer complaints through effective problem-solving techniques, improving overall service quality.
- Utilized CRM software to track interactions and ensure accurate record-keeping for follow-up actions.
- Provided exceptional customer service by actively listening to inquiries and offering personalized solutions.
- Demonstrated empathy towards customer concerns, fostering trust and rapport during interactions.
- Managed high call volume while remaining focused on delivering excellent customer experiences.
- Collaborated with team members to streamline processes, resulting in improved response times and service delivery.
- Increased first call resolution rates by utilizing comprehensive product knowledge and problem-solving skills.
- Improved customer satisfaction by efficiently addressing and resolving issues in a timely manner.
- Collaborated with cross-functional teams to provide seamless support for customers during various stages of the service process.
- Exceeded performance metrics by consistently maintaining high-quality interactions with customers.
- Facilitated conflict resolution between customers and other departments when necessary, ensuring satisfactory outcomes for all parties involved.
- Maintained up-to-date knowledge of product and service changes.
- Met customer call guidelines for service levels, handle time and productivity.
- Promptly responded to inquiries and requests from prospective customers.
- Educated customers about billing, payment processing and support policies and procedures.
- Promoted superior experience by addressing customer concerns, demonstrating empathy, and resolving problems swiftly.
Education
Associate of Arts - Business Administration
Dallas College
Dallas, Texas, TX08-2026
Skills
- Accuracy and precision
- Healthcare regulations
- Policy interpretation
- Verbal and written communication
- FMLA comprehension
- Active listening
- Computer proficiency
- Call center experience
- Problem resolution
- Critical thinking
- Prioritization
- De-escalation techniques
- Proofreading
Timeline
Benefits Verification Specialist
CVS
06.2023 - 10.2025
Contact Center Representative
United States Mint
08.2021 - 05.2023
Associate of Arts - Business Administration
Dallas College