Empres Wiley
Raleigh,NC
Summary
Versatile and highly motivated professional with over four years of experience in customer service, claims processing, and case management across government, hospitality, and insurance industries. Recognized for strong problem-solving skills, attention to detail, and the ability to communicate clearly and effectively in fast-paced, client-facing environments. Experienced in handling sensitive information, processing claims, reporting, and improving workflow efficiency using various tools, bringing a growing foundation in administrative support and a strong commitment to learning and professional development.
Overview
3
3
years of professional experience
1
1
Certification
Work History
Case Manager
Wake County Temporary Services
11.2024 - 04.2025
- Managed a diverse caseload of clients, assessing eligibility for public assistance programs such as child care subsidies.
- Conducted comprehensive interviews and needs assessments to determine appropriate services and develop individualized service plans.
- Interpreted and applied state and federal policies to ensure accurate benefit determinations and compliance with regulatory requirements.
- Maintained detailed and confidential case documentation using case management systems, ensuring timely updates and audit readiness.
- Provided ongoing case monitoring, follow-ups, and referrals to community resources, including housing, employment, and mental health services.
- Collaborated with interdisciplinary teams, including social workers, healthcare providers, and legal representatives, to support client stability and self-sufficiency.
- Educated clients on program requirements, responsibilities, and available resources to promote informed decision-making.
- Demonstrated cultural sensitivity and professionalism while supporting vulnerable populations facing complex social and economic challenges.
Disability Claims Processor
MetLife
11.2023 - 11.2024
- Reviewed and processed disability claims with a focus on accuracy, policy compliance, and timely resolution.
- Assessed medical records, employment data, and documentation to determine claimant eligibility in accordance with federal, state, and program-specific guidelines.
- Drafted detailed approval and denial letters, clearly outlining decisions and ensuring compliance with legal and procedural requirements.
- Maintained confidential case files and updated internal databases to reflect the latest claim statuses and supporting documentation.
- Communicated professionally with claimants, healthcare providers, and employers to gather additional information and provide status updates.
- Managed appeals and reconsideration cases, analyzing new evidence and collaborating with senior reviewers as needed.
- Ensured adherence to HIPAA regulations and agency standards for sensitive data handling and documentation.
- Delivered high-quality customer service with empathy and clarity to support individuals navigating the disability claims process.
Complaint Resolution Official
Breeze Airways
05.2023 - 01.2024
- Conversed with customers to evaluate travel needs and preferences.
- Kept passengers moving smoothly by using PA system to announce arrivals and departures.
- Documented, researched and resolved customer service issues.
- Approached and solved problems with initiative and sound judgment.
- Organized files and records and handled other support tasks, freeing up managers to take on more pressing responsibilities.
- Listened to customer requests and specifications and made suggestions to appropriately fulfill needs.
- Offered to assist with additional tasks to keep projects on-task and meet tight deadlines.
- Delivered exceptional customer service to bolster strong relationships and build.
Call Center Agent
IHG Hotels & Resorts
04.2022 - 05.2023
- Kept impeccable administrative and financial records, verified transactions and updated records.
- Uphold accurate record-keeping, accounting and payment handling.
- Enquired after, received and recorded service feedback from departing guests.
- Received heavy inbound calls on multiple lines.
- Listened to and professionally resolved minor complaints from guests.
- Refunded deposits and completed guest accounting functions.
- Escalated problems or unusual matters to supervisor for prompt corrective action.
Education
Accounting And Finance
Wake Technical Community College
Raleigh12.2025
Skills
- Self-Starter
- Problem Solving
- Claims processing
- Case management
- Data-Entry
- Math Skills
- Quality Assurance
- Strong Written & Verbal Communication
- Complaint resolution
- Critical thinking
- Positive and professional
- Interpersonal skills
- Computer Skills
- Microsoft Office 365
- Relationship building
- Attention to Detail
- Collaboration & Teamwork
- Adaptability & Continuous Learning
Certification
- Certificate - Customer Service Executive, Alison, Online, 5349-30134011
- Introduction to Web Development & HTML, LinkedIn.com
Education
false
Timeline
Case Manager
Wake County Temporary Services
11.2024 - 04.2025
Disability Claims Processor
MetLife
11.2023 - 11.2024
Complaint Resolution Official
Breeze Airways
05.2023 - 01.2024
Call Center Agent
IHG Hotels & Resorts
04.2022 - 05.2023
Accounting And Finance
Wake Technical Community College