GAELENE CLAPSHAW
West Valley City,UT
Summary
Organized customer service and operations professional with experience in claims processing, order fulfillment, and issue resolution. Brings strong time management, accuracy, and communication skills to support efficient workflows, verify details, and help customers with timely, reliable service.
Overview
23
23
years of professional experience
Work History
Digital Personal Shopper
Walmart
West Valley City, Utah
07.2025 - Current
- Selected grocery and general merchandise items through the Walmart mobile order system.
- Facilitated Walmart customers' digital order pickup and delivery substitutions, ensuring satisfaction with an alternative.
- Informed customers and store associates of product availability and suitable replacement options, and enhancing customer experience.
- Verified order accuracy before staging items for pickup or delivery.
- Resolved order issues using Walmart handheld devices and digital shopping tools.
- Collaborated with Walmart departments to efficiently locate items and fulfill customer orders, improving order accuracy.
- Followed Walmart store procedures for item handling, packing, and customer service.
Claims Processor
Blue Shield of CA
Redding, California
10.2022 - 06.2025
- Processed Blue Shield of California claims through internal adjudication systems.
- Processed claims per established quality and production standards, correcting and adjusting issues to maintain accuracy.
- Processed high volume of incoming claims per established policies and procedures, contributing to timely resolution.
- Reviewed member eligibility, benefits, and coverage details to support claim decisions.
- Updated claim files with accurate notes, codes, and supporting documents to ensure compliance and facilitate review.
- Followed HIPAA guidelines while managing confidential member information.
Appeals and Grievances
Blue Shield of California
Redding, CA
10.2017 - 10.2022
- Worked closely with team members to deliver project requirements, develop solutions and meet deadlines.
- Prioritized and organized tasks to efficiently accomplish service goals.
- Displayed independence in completing assigned tasks by meeting and exceeding workflow needs.
- Worked successfully with a diverse group of coworkers to accomplish goals and address issues related to our products and services.
Customer Service Associate
Blue Shield of CA
Redding, CA
05.2003 - 10.2017
- Provided fast, friendly service for routine inquiries and resolved service complaints effectively.
- Enhanced customer relations by providing friendly, knowledgeable communication aligned with service goals.
- Upheld strict quality control policies and procedures during customer interactions.
- Prioritized tasks and managed activities to meet strict deadlines consistently.
Education
Associate of Arts - Medical Office Specialist
Shasta College
Redding, CA05-2003
High School Diploma -
Cyprus High School
Magna, UT06-1988
Skills
- Order processing
- E-commerce tools
- Order fulfillment
- Inventory management
- Customer engagement
- Customer service
- Retail customer service
- Call Center Operations
- Attention to detail
- Problem solving
- Time management
- Adaptability and flexibility
- Courteous demeanor
- Microsoft Office expertise
- Performance evaluation
Timeline
Digital Personal Shopper
Walmart
07.2025 - Current
Claims Processor
Blue Shield of CA
10.2022 - 06.2025
Appeals and Grievances
Blue Shield of California
10.2017 - 10.2022
Customer Service Associate
Blue Shield of CA
05.2003 - 10.2017
Associate of Arts - Medical Office Specialist
Shasta College
High School Diploma -
Cyprus High School