Kehana McAfee-Williams
Milwaukee
Summary
Achieved high customer satisfaction ratings through effective problem-solving and support. Cultivated lasting client relationships that contributed to business expansion. Drove team success by promoting a positive and motivated work atmosphere.
Overview
18
18
years of professional experience
Work History
Senior Client Service Representative
Northwestern Mutual
Franklin, WI
01.2020 - Current
- Cultivated sustainable client relationships founded on trust through exceptional communication and interpersonal skills.
- Cultivated strong client relationships by delivering exceptional service and support.
- Conducted needs analysis and presented tailored options to empower customer decision-making.
- Oversaw management and updates of physical and digital client account information to ensure accuracy and currency.
- Addressed and resolved client concerns by researching relevant details and communicating effective solutions.
- Executed follow-up communications with customers via calls and emails to proactively address issues.
Claims Representative
UnitedHealth Group
Milwaukee, WI
08.2007 - 01.2020
- Delivered exceptional customer service to insured clients and claimants throughout claims process.
- Analyzed documentation and accounts to ensure comprehensive understanding of operations.
- Facilitated efficient management of complex claims and ensured timely follow-up on denied or suspended claims to fulfill necessary line items.
- Managed claims resolution by approving or denying documentation and calculating benefits due.
- Oversaw adherence to policies and procedures regarding insurance coverage benefits and eligibility verification systems.
- Validated claim data accuracy to ensure seamless processing.
- Analyzed historical records to assess benefit eligibility for services.
- Evaluated medical claims for validity to ensure accurate resolution of discrepancies.
- Executed claims processing in alignment with established quality and production standards.
- Reviewed documentation to ensure accurate coding and rectify errors.
- Evaluated and processed healthcare claims to ensure accuracy, completeness, and compliance with Medicare regulations.
Education
Associate of Science - Liberal Arts And Sciences
Milwaukee Area Technical College
Milwaukee, WISkills
- Membership renewals
- Account management
- Customer support
- Database maintenance
- Inbound and Outbound Calling
- Credit card payment processing
- Conflict mediation
- Call Center Operations
- Microsoft Office expertise
- High-energy attitude
- Data evaluation
- Cross-functional collaboration
Timeline
Senior Client Service Representative
Northwestern Mutual
01.2020 - Current
Claims Representative
UnitedHealth Group
08.2007 - 01.2020
Associate of Science - Liberal Arts And Sciences
Milwaukee Area Technical College