Kaniyah Jones
Clayton,NC
Summary
Dedicated, upbeat, knowledgeable, and efficient Member Services Representative equipped to managing positive member interactions and provide exemplary customer service. Promote products and services, answer questions, and seek timely resolutions to satisfy members and maintain high productivity. Excellent communicator with attention to detail and good account and time management skills.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Warehouse Associate
Amazon
01.2023 - 08.2023
- Safely & efficiently utilize the warehouse material handling equipment
- Build stable, well-built accurate pallet loads for shipment
- Consistently pick, load, receive and replenish product to meet established company production and service levels
- Ensure that shipping schedules are met with attention to detail to ensure timely delivery and loss prevention; working with a small group in the warehouse to ensure items are retrieved, organized, and shipped in a timely manner
- Prepared orders for shipment by picking, packing, and labeling merchandise.
Customer Claims Resolutionist
Cigna
07.2022 - 12.2022
- Discuss policy coverage and deductible amounts while navigating through multiple systems
- Schedule and review appeal and claims to explain discrepancies
- Schedule appointments on a member basis based on provider availability
- Review code editing, and diagnosis cross matching to explain coverage of services
- Outreach to providers, billing, case managers, and insurance firms to investigate customer resolution
- Verify claim status to assess readjustment while coordinating with appropriate claims processing team
- Eligibility verification and benefit overviews to submit claim information for processing.
- Responded to customer requests for products, services, and company information.
- Answered incoming phone calls to articulate product value to prospective customers and support current policyholders.
Delivery Driver
Uber Eats
05.2021 - 07.2022
- Quickly and accurately respond on short notice while actively communicating with customers
- Completed deliveries on time by choosing most efficient route
- Efficiently solved administrative issues between customers, merchants, and company
- Maintained vehicle maintenance and cleaning
- Worked extended hours at high level of efficiency
- Delivered packages to customer doorsteps and business offices.
- Maintained upbeat, positive attitude in busy, customer-focused environment.
Provider Representative
Aetna
03.2021 - 05.2021
- Coordinate with providers to discuss plan coverage, review beneficiaries and proper coding for billing
- Investigated and resolved customer inquiries and complaints quickly.
- Communicate through fax and emails to document medical records
- Capturing data to support claims decision, creating status reports
- Establishing and maintain relationships with providers.
- Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
Services Specialist
United States Air Force, USAF
10.2019 - 03.2021
- Investigated performance issues and calibrated settings to achieve the optimal output
- Followed up with customers to offer additional support and check resolution satisfaction.
- Supervised maintenance and repair of power and pneumatic tools to maintain peak performance
- Verified completed work against health and safety programs and regulations
- Applied critical thinking in inspecting, troubleshooting, and diagnosing equipment
- Continuously met or exceeded daily service quality and performance scores
- Maintained good working relationship with co-workers and management
- Completed all required paperwork within anticipated timeframes.
Support Services Supervisor
United States Air Force, USAF
11.2019 - 07.2020
- Communicated with clients to address concerns or facilitate connection with executives
- Assisted with board meetings, including document preparation, minutes, and catering
- Managed office administration, including filing, research, and document control
- Supervised front end associates in fast-paced and demanding environment
- Obtained compliance with company policies and procedures in processing transactions with customers
- Boosted team performance by closely monitoring the work of each staff member and offering motivational support
- Oversaw the work of 15-20 team members supporting administrative efforts to better the workplace.
- Coached employees through day-to-day work and complex problems.
- Set priorities and problem-solved workflow issues to maintain rapport with customers and managers.
Services Representative
United States Air Force, USAF
07.2017 - 10.2019
- Accurately prepared and processed forms to change customer service levels
- Pleasantly greeted customers, repeated orders back to customers accurately, provided samples, and completed transactions
- Engaged with customers to understand and resolve issues and answer product questions
- Processed product orders, including entering customer orders and completing stock replenishment orders
- Used proven techniques to increase sales and promote high-value products
- Referred unresolved customer grievances to designated departments for further investigation
- Sold products effectively by demonstrating product features, employing technical product knowledge to describe capabilities and limitations for customers
- Handled customer issues with confidence, using complex problem solving to provide effective resolution.
Basic Military Training
United States Air Force, USAF
03.2017 - 05.2017
- Assessed situations quickly to prioritize action, restore order, and prevent serious destruction of property
- Participated in continuous firearms proficiency, defensive driving and arrest technique training.
- Employed analytical mindset to remain calm in highly stressful situations
- Addressed concerns quickly to avoid lasting issues
- Completed all assigned tasks before shift end.
- Provided emergency response security, eliminating hazards, and potential dangers.
- Built excellent rapport and working relationship with community to build trust and improve upon communication.
Education
Bachelor of Science - Psychology
Grand Canyon University
Phoenix, AZ10.2025
High School Diploma -
ROBERT E LEE HIGH SCHOOL
JACKSONVILLE, FL06.2016
Skills
- Customer Service excellence
- Critical thinking/ Problem resolution
- Order processing
- Product and Decision making
- In and outbound call
- Microsoft Excel
- Data Entry
- Record keeping
- Organization/ Time management
- Medical terminology
- Navigating multiple systems
- Scheduling
Certification
- Basic Life Support Certification, American Health- 8/18/23-8/18/25
Reading, Yoga , Baking
I an an enthusiastic reader specific to self help and psychological development. I enjoy the nature of reading because it allows to to travel outside of self perception. I am and avid supporter of fitness and self regulation. Yoga gives me to opportunity to decompress my mind and body simultaneously. Lastly, baking is traditional in my family. I love the precision and tedious nature of baking. I learned from my grandmother and will continue to spread this knowledge for generations.
Timeline
Warehouse Associate
Amazon
01.2023 - 08.2023
Customer Claims Resolutionist
Cigna
07.2022 - 12.2022
Delivery Driver
Uber Eats
05.2021 - 07.2022
Provider Representative
Aetna
03.2021 - 05.2021
Support Services Supervisor
United States Air Force, USAF
11.2019 - 07.2020
Services Specialist
United States Air Force, USAF
10.2019 - 03.2021
Services Representative
United States Air Force, USAF
07.2017 - 10.2019
Basic Military Training
United States Air Force, USAF
03.2017 - 05.2017
Bachelor of Science - Psychology
Grand Canyon University
High School Diploma -
ROBERT E LEE HIGH SCHOOL
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