Jeshay Maupin
Fayetteville,NC
Summary
Dedicated Healthcare Customer Service Representative with expertise in patient communication and data accuracy. Utilize active listening and problem-solving skills to enhance patient satisfaction and achieve team goals. Experienced in client service and knowledgeable in healthcare policies.
Overview
9
9
years of professional experience
Work History
SR Client Service Advisor
Blue Cross And Blue Shield Of NC
Alger
05.2023 - Current
- Served as a primary point of contact for clients, responding to inquiries and providing exceptional service throughout the reporting process.
- Built and maintained strong client relationships through proactive communication, responsiveness, and personalized service.
- Prepared and delivered customized client reports, including Advice Requests, Financial Reports, and Wellness Reports, ensuring accuracy and timely completion.
- Explained report findings to clients in a clear, professional manner, helping them understand financial trends and recommendations.
- Analyzed client data to generate comprehensive reports that supported financial planning and informed decision-making.
- Collaborated with internal teams to gather and validate financial data, enhancing accuracy in client presentations and reporting.
- Maintained accuracy and confidentiality while handling sensitive client financial information in accordance with company policies and regulatory standards.
- Utilized multiple systems and reporting tools to compile, review, and distribute client-specific financial and wellness information.
- Identified and implemented improvements in reporting processes, enhancing client experience and operational efficiency.
Coaching Advisor
Blue Cross And Blue Shield Of NC
10.2019 - 05.2023
- Coached and mentored customer service representatives through live and recorded call reviews, providing actionable feedback to improve performance, quality, and customer satisfaction.
- Conducted side-by-side coaching sessions focused on communication, problem-solving, de-escalation, and effective call-handling techniques.
- Handled escalations for members and providers, ensuring timely resolution of complex issues.
- Resolved complex issues for members and providers, ensuring adherence to healthcare policies and delivering high-quality customer service.
- Demonstrated active listening skills during member interactions
- Verifying and explaining medical, dental, vision and prescription benefits with members
- Reviewed and explained claims, including bluecard home, ensuring accuracy and facilitating necessary corrections.
- Walking member through blue connect accounts to obtain information, including but not limited to benefits, claims and finding a provider online
- Connecting members to various departments to fulfill the needs of their call if
- Creating responses for providers
- Communicated with healthcare providers through phone, fax, email, and chat to gather and provide information needed to resolve claims, benefits, eligibility, and member-related inquiries.
- Conducted provider outreach to obtain required documentation and clarify information necessary for timely and accurate issue resolution.
- Assisted representatives with interpreting healthcare benefits, policies, and procedures to ensure accurate and consistent information was provided.
- Reviewed claims and explained Explanation of Benefits (EOBs), coverage details, and benefit information to members and providers.
- Verified HIPAA authorization before accessing or releasing protected health information and maintained compliance with privacy requirements.
- Processed member requests for ID cards and benefit booklets while ensuring accurate and timely fulfillment.
- Monitored quality assurance standards and reinforced compliance with company policies, regulatory requirements, and customer service expectations.
- Identified performance trends and collaborated with leadership to create tailored coaching plans for targeted improvement.
- Documented coaching sessions, tracked agent progress, and followed up on action plans to support continuous performance improvement.
- Identified performance trends and collaborated with leadership to create tailored coaching plans for targeted improvement.
- Documented coaching sessions, tracked agent progress, and followed up on action plans to support continuous performance improvement.
Customer Service
AT&T, CSR
01.2018 - 10.2019
- Mi60(manager 60, Improved call center functionality and service capacity by resolving customer complaints efficiently and quickly
- Defused volatile customer situations calmly and courteously
- Addressed and resolved customer product complaints empathetically and professionally
- Answered an average of 180calls per day by addressing customer inquiries, solving problems and providing new product information
- Managed addition and removal of customer plans/ plan explanation
- Transferred customer calls to appropriate departments
- Achieved monthly performance goals based on customer survey feedback, contributing to service quality improvement
- Met monthly performance stats based off customer surveys
- Facilitated communication between billing department and customers to effectively resolve issues and improve customer experience
- Processed credit payments rapidly and accurately
Education
Associate of Applied Business -
Wake Technical Community College
Raleigh, NC 08.2026 - 08.2026
High School Diploma - Billing And Coding
B Wilkins
AlgerSkills
- Client Relationship Management
- Client engagement
- Client Needs Assessment
- Client Onboarding Process
- Issue resolution
- Dispute resolution
- Healthcare Compliance Standards
- Healthcare Service Expertise
- Claims Processing Knowledge
- Data Analysis Techniques
- Data Management Techniques
- Attention to detail
- Time management
- Professional under pressure
- Service Offerings Knowledge
- HIPAA compliance
Timeline
Associate of Applied Business -
Wake Technical Community College
08.2026 - 08.2026
SR Client Service Advisor
Blue Cross And Blue Shield Of NC
05.2023 - Current
Coaching Advisor
Blue Cross And Blue Shield Of NC
10.2019 - 05.2023
Customer Service
AT&T, CSR
01.2018 - 10.2019
High School Diploma - Billing And Coding
B Wilkins