Keirra Jones
Tempe,USA
Summary
Customer-focused professional with strong experience in customer service, claims processing, and project coordination. Through experience have developed the ability to handle high-volume inquiries, resolve complex issues, and communicate effectively with clients, healthcare providers, and insurance carriers. With focus on delivering high standards and achieving results. Strong collaborator, adaptable to changing needs, and skilled in active listening and conflict resolution.
Overview
8
8
years of professional experience
Work History
Customer Experience Associate II
Conduent, LLC
11.2023 - Current
- Serve as the primary point of contact for patients and healthcare providers in a large pharmaceutical company’s patient assistance program.
- Assist with the processing of over 40+ program applications per day, refill/reorder requests, and documentation verification.
- Ensure accurate record-keeping and compliance with program guidelines.
- Suggested operational improvements to enhance quality, and improve production times.
- Cross-trained and provided backup support for organizational leadership.
Claims/Customer Service Representative I
Ameritas, LLC
10.2021 - 07.2022
- Acted as a liaison between groups, employees, and insurance carriers to resolve claims-related issues.
- Reviewed and processed insurance claims, ensuring accuracy and compliance with company policies.
- Investigated and resolved claim discrepancies, communicated with providers, and processed appeals.
- Maintained thorough documentation and delivered exceptional customer service.
- Reduced errors in claim submissions by providing clear guidance to policyholders on required documentation and information needed for processing.
- Promoted a positive work environment by actively participating in team meetings, sharing best practices, and offering constructive feedback to peers.
- Abilities to maintain high call volume while processing 80+ claim workload per working day.
Customer Care Representative I
CVS Health
10.2020 - 05.2021
- Provided guidance to members regarding benefits, eligibility, and claims processing.
- Managed refill requests, order tracking, and issue resolution for prescription services.
- Navigated multiple systems efficiently to document and address customer concerns.
- Utilized CRM systems to accurately track customer interactions and update account information.
- Managed high call volume with exceptional professionalism and efficiency.
Projector Coordinator
Lowe's, LLC
08.2019 - 01.2020
- Coordinate staff schedules according to project deadlines and budget requirements
- Communicate with clients to discuss project objectives and requirements
- Analyzed data to identify and address projects risks
- Collaborate with cross-functional teams to ensure successful project results
- Report project status on budget, resources, technical issues, and customer satisfaction
- Plan, schedule, and coordinate project activities to meet deadlines
- Propose, review and approve modifications to project plans
- Approve finalization and completion of project and negotiated compensation per contractors signed agreement
Customer Care Advocate
Caresource, LLC
05.2017 - 09.2018
- Utilized customer service software to streamline processes
- Update claims status information, benefits coverage, plan eligibility regarding dental, vision, and pharmacy benefits
- Handle sensitive member information with discretion while prioritizing effectively to meet service goals/deadlines
- Answer a high volume of inbound calls, emails, voicemail and online reviews to answer customer inquiries according to standard operating procedures
- Record and report all information regarding client inquiries, issues, or complaints into the company's tracking and reporting system
- Develop and maintain positive rapport with customers by providing timely, accurate information and solutions to their inquiries or problems
Education
High School - GED
Milwaukee Achiever’s Vocational School
Milwaukee, WI01.2010
Skills
- CRM & Data Management
- Client advocacy
- Teamwork and collaboration
- Multitasking & Time Management
- Claims Processing
- Strong Communication & Interpersonal skills
- Customer Engagement
- Project Coordination & Scheduling
Additional Information
References Available Upon Request
Timeline
Customer Experience Associate II
Conduent, LLC
11.2023 - Current
Claims/Customer Service Representative I
Ameritas, LLC
10.2021 - 07.2022
Customer Care Representative I
CVS Health
10.2020 - 05.2021
Projector Coordinator
Lowe's, LLC
08.2019 - 01.2020
Customer Care Advocate
Caresource, LLC
05.2017 - 09.2018
High School - GED
Milwaukee Achiever’s Vocational School
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