Summary
Overview
Work History
Education
Skills
Personal Information
Timeline
Generic

Jalesa Floyd

Birmingham,AL

Summary

Experienced professional seeking full-time employment to positively impact and inspire the public. Demonstrating a strong work ethic, dependability, and honesty, I bring creative thinking and excel at leading and collaborating within teams. Prioritizing quality and efficiency, I consistently achieve exceptional results.

Overview

10
10
years of professional experience

Work History

Customer Service Representative

Chenega Corporation
10.2024 - Current
  • Manages multiple tasks lists in accordance with directed timelines
  • Meets call volume, chat volume, schedule adherence, quality, Veteran appointment and other production standards
  • Initiates and receives phone calls, chat messages and emails from VA medical center staff, and providers to answer claims, eligibility, and benefit and program questions
  • In select markets, facilitates appointment scheduling of Veterans through outbound solicitation to providers
  • Records preferences, tracks Veteran questions thoroughly in the TriWest's Customer Relationship Management systems and Portal, as well as VA's HSRM systems
  • Consistently displays professional and courteous service skills to internal and external customers
  • Accurately resolves VA and provider inquiries with a focus on first call resolution
  • Protects the privacy of health information of patients when using or disclosing Protected Health Information (PHI)
  • Takes appropriate measures to comply with HIPAA regulations to protect privacy of customers' health information
  • Documents all communications involving Veteran and provider contacts
  • Uses critical thinking in problem solving and follows established processes to assure quality program compliance
  • Consistently meets department productivity and performance metrics to include regular and consistent attendance
  • Participates in cross training, employee development and flexible assignments to ensure business needs are met

Claims Benefit Specialist

Aetna, a CVS Health Company
01.2023 - 10.2024
  • Determines covered insurance losses by studying provisions of a policy or certificate
  • Establishes proof of loss by studying documentation and assembling additional information from outside sources
  • Documents specific claims by completing and recording forms, reports, logs, and records
  • Analyzes insurance claims to prevent fraud
  • Prepares reports by collecting, analyzing, and summarizing information
  • Resolves claims by approving or denying documentation, calculating benefits due, and determining compensation settlement
  • Ensures legal compliance by following company policies, procedures, and guidelines, as well as state and federal insurance regulations
  • Maintains quality customer service by following customer services practices and responding to customer inquiries
  • Provides legal support by assembling documentation for settlement action
  • Protects operations by keeping claims information confidential
  • Maintains a good relationship with insurance departments

Receptionist/Applicant Onboarding Assistant

Helping Hearts
05.2024 - 06.2024

• Applicant Onboarding

• Applicant Interviews

• Applicant background checks/ TB SKIN TEST

• Assist the CEO & Branch Manager With Daily Tasks.

• Applicant Hiring

  • Greeted clients and visitors, enhancing overall customer service experience. Managed appointment scheduling to ensure smooth daily operations.
  • Directed phone calls to appropriate departments, improving communication efficiency. Assisted in maintaining clean and organized reception area for a welcoming environment.
  • Responded to inquiries promptly, providing accurate information to clients. Monitored office supplies inventory, placing orders to maintain stock levels.
  • Learned and adapted quickly to new technology and software applications. Used critical thinking to break down problems, evaluate solutions and make decisions.
  • Demonstrated strong organizational and time management skills while managing multiple projects.
  • Developed and maintained courteous and effective working relationships.

Customer Service Representative

Blue Cross Blue Shield
01.2022 - 12.2022
  • Ensures effective customer relations by responding accurately, timely and courteously to telephone, written, web, or walk-in inquiries
  • Accurately documents inquiries
  • Initiates or processes adjustments or performs other research as needed to resolve inquiries
  • Coordinates with other departments to resolve problems
  • Responds to, researches and/or assists with priority inquiries and special projects as required by management
  • Provides feedback to management regarding customer problems, questions and needs
  • Maintains accurate records on complaints and/or other customer comments, and makes recommendations for changes to management
  • Follows through on complaints until resolved or reports to management as needed
  • Maintains basic knowledge of quality work instructions and company policies
  • Assists with process improvements through the recommendation of changes in procedures and techniques discovered during daily operations
  • Maintains all departmental productivity, quality, and timeliness standards
  • Identifies and promptly reports and/or refers suspected fraudulent activities and system errors to the appropriate departments

Mail Processing Clerk

USPS
09.2020 - 12.2021
  • Manually sort mail for shipping

CSR - Customer Service Representative

Social Security Administration
10.2019 - 09.2020
  • Gather facts and evidence to determine if someone is eligible for benefits
  • Help the public by answering a wide variety of questions both in-person and by telephone

Stocker Associate

Dollar General Distribution
02.2019 - 10.2019
  • Stock merchandise for the pickers to package, for shipping to all company stores

General Warehouse Associate

Home Depot Distribution
02.2018 - 02.2019
  • Prepare all freight for shipping
  • Load & unload trucks

Security Officer/Security Dispatcher

Allied Universal
09.2016 - 02.2018
  • Provide security services to a professional office building
  • Security dispatcher at Brookwood Mall
  • Monitor CCTV

Specimen Accessioner

Labcorp
08.2015 - 08.2016
  • Prepare specimens for routine lab testing

Pse clerk

USPS
11.2014 - 07.2015
  • Sorted, organized, & prepared all mail for shipping

Education

High school or equivalent -

Maranathans Academy
Birmingham, AL
12.2008

Skills

  • Pallet Jack Operation
  • Food Service Experience
  • Proficient in Computer Applications
  • Sales Expertise
  • Client Support
  • Effective Communication
  • Skilled in Microsoft Word Applications
  • Efficient Calendar Coordination
  • Staff Guidance Expertise
  • Courteous Call Management
  • Deadline-Driven Planning
  • Assembly Line Operations
  • Onboarding Coordination
  • Facilitating Training Sessions
  • Strategic Evaluation Skills
  • Calendar Management

Personal Information

  • Willing To Relocate: Anywhere
  • Authorized To Work: US for any employer

Timeline

Customer Service Representative

Chenega Corporation
10.2024 - Current

Receptionist/Applicant Onboarding Assistant

Helping Hearts
05.2024 - 06.2024

Claims Benefit Specialist

Aetna, a CVS Health Company
01.2023 - 10.2024

Customer Service Representative

Blue Cross Blue Shield
01.2022 - 12.2022

Mail Processing Clerk

USPS
09.2020 - 12.2021

CSR - Customer Service Representative

Social Security Administration
10.2019 - 09.2020

Stocker Associate

Dollar General Distribution
02.2019 - 10.2019

General Warehouse Associate

Home Depot Distribution
02.2018 - 02.2019

Security Officer/Security Dispatcher

Allied Universal
09.2016 - 02.2018

Specimen Accessioner

Labcorp
08.2015 - 08.2016

Pse clerk

USPS
11.2014 - 07.2015

High school or equivalent -

Maranathans Academy
Jalesa Floyd