Jakia Calloway
Dallas,TX
Summary
Detail-oriented professional with a proven track record in quality assurance and claims management. Expertise in effective communication enhances customer service and satisfaction. Committed to maintaining client confidentiality while delivering timely resolutions that elevate overall customer experience.
Overview
7
7
years of professional experience
Work History
Claims Advocate
Humana
05.2023 - 06.2026
- Analyzed claim data to identify trends, enhancing accuracy in claims processing and reporting.
- Investigated and resolved claims discrepancies, ensuring compliance with company policies and regulatory standards.
- Oversaw quality assurance for processed claims, ensuring compliance with operational guidelines and meeting client expectations.
- Streamlined claims process and prioritized high-priority cases, enhancing claim resolution times.
- Reduced customer complaints by providing timely and accurate updates on claim status.
- Provided exceptional customer service to clients during stressful situations,earning positive feedback from satisfied customers.
- Assisted clients in understanding policy coverage and benefits, resulting in better- informed decisions about their claims.
- Educated clients on loss prevention strategies to minimize future risks and potential claim costs.
- Managed sensitive client information with strict confidentiality, adhering to data protection laws and guidelines at all times.
Overnight Customer Service Representative
Anthology
11.2020 - 03.2023
- Managed overnight customer support operations, ensuring timely responses to service requests and maintaining service quality.
- Monitored live chats and calls to maintain high standards of service quality during shifts.
- Resolved customer inquiries and issues through effective communication via phone and chat platforms.
- Collaborated with team members to address escalated customer concerns efficiently and promptly.
- Improved customer satisfaction by effectively resolving inquiries and concerns, contributing to a positive customer experience.
- Managed high-volume phone lines, ensuring prompt responses and accurate information dissemination.
- Expedited order processing to enhance customer experience and ensure timely deliveries.
- Trained new representatives on company policies and systems for optimal performance.
- Provided backup to team members during high-demand periods to maintain efficiency. by providing backup assistance.
Claims Operations Associates
VXI
07.2019 - 11.2020
- Resolved high-volume customer inquiries and managed workflows to ensure timely claims processing.
- Enhanced operational efficiency and customer satisfaction by coordinating complex claims resolutions.
- Improved processing accuracy through analysis of claims data trends.
- Reduced claim disputes through effective communication and detailed documentation practices.
- Addressed policyholder concerns with exceptional customer service throughout claims the claims process.
- Coordinated workflow and reviewed accounts to maintain process compliance.
- Updated records to ensure accurate quality assurance standards were met.
Education
A. Maceo Smith High School
Dallas05-2009
Skills
- Claims processing
- Claims investigation
- Claims data analysis
- Quality assurance
- Policy coverage education
- Claims Management Software
- Customer relationship management
- Call Center Technology
- Customer Interaction Tools
- Verbal Communication
- Client confidentiality
Timeline
Claims Advocate
Humana
05.2023 - 06.2026
Overnight Customer Service Representative
Anthology
11.2020 - 03.2023
Claims Operations Associates
VXI
07.2019 - 11.2020
A. Maceo Smith High School