Keisha Webb
Dallas,TX
Summary
Experienced professional with a strong background in claims management and team coordinator -related roles. Skilled in employing engaging training methods and implementing improved training programs to improve performance. Experienced handling teams of several members. Capable of managing projects and collaborating effectively with teams. Dedicated in providing support, guidance, leadership and motivation to promote maximum performance in fast-paced working environment. Known for successfully handling escalated customer support issues. Self-motivated with collaboration, leadership and talents.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Team Coordinator
Sedgwick
Irving, TX
02.2022 - 09.2024
- Assist with supervision of multiple team examiners, multiple product line examiners and/or several technical operations colleagues for a wide span of control; may delegate some duties to others within the unit.
- Organized and scheduled team meetings, conference calls and video conferences.
- Identifies and advises management of trends, problems, and issues as well as recommended course of action; informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for the office.
- Provides technical/jurisdictional direction to examiner reports on claims adjudication.
- Compiles reviews and analyzes management reports and takes appropriate action.
- Performs quality review on claims in compliance with audit requirements, service contract requirements, and quality standards.
- Provided administrative support for the team, such as creating presentations, taking notes during meetings, preparing agendas and maintaining records of key decisions.
- Reviews reserve amounts on high cost claims and claims over the authority of the individual examiner.
- Monitors third party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client.
- Maintains contact with the client on claims and promotes a professional client relationship; makes recommendations to client as suggested by the claim status; and provides written resumes of specific claims as requested by client.
- Oversaw staffing and scheduling for team of employees to keep workflows running efficiently.
- Collaborated with management team to meet organizational and departmental goals.
- Ensures claims files are coded correctly and adequate documentation is made by claims examiners.
- Interviews, hires, and establishes colleague performance development plans; conducts colleague performance discussions.
Disability Representative I and II
Sedgwick
Irving, TX
11.2010 - 02.2022
- Medically manages disability claims ensuring compliance with duration control guidelines and plan provisions. Informs claimants of documentation required to process claims, required time frames, payment information and claims status either by phone, written correspondence and/or claims system.
- Evaluates and arranges appropriate referral of claims to outside vendors for surveillance, independent medical evaluation, functional capability evaluation, and/or related disability activities.
- Provided customer service by answering product and service related questions.
- Reviewed medical records and other pertinent documents to evaluate the severity of a disability.
- Advised claimants about their rights and responsibilities under applicable laws and regulations.
- Resolved customer complaints in a professional manner while remaining empathetic to their concerns.
- Determines benefits due, makes timely claims payments and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets.
- Informs claimants of documentation required to process claims, required time frames, payment information, and claims status either by phone, written correspondence, and/or claims system.
Service Center Representative Sr.
Sedgwick
Irving, TX
03.2010 - 11.2010
- Provided customer service to customers over the phone and answered incoming calls from customers promptly and professionally.
- Act as a liaison between customers and team members; direct calls to appropriate escalation path as needed.
- Provide detailed notes on phone calls, and track and code documentation according to standard processes.
- Follows client specifications in assisting with questions and solving problems related to the claims application and servicing processes.
- Entered verbal and written application information that meets both the internal and external customers requirements accurately into the claims management system.
- Educates and informs the customer through multiple communication channels about documentation required to process a claim, required time frames, payment information, and claim status.
- Escalated unresolved customer issues to a supervisor when necessary.
- Trained new staff members on proper customer service protocols.
- Provided feedback on ways to improve overall customer experience.
- Answered inquiries from customers regarding their individual claims status.
- Ensured compliance with applicable laws, regulations, standards, policies.
Claims Assistant
Sedgwick
Irving, TX
07.2007 - 03.2010
- Assisted in the preparation of documents for claims processing.
- Processes payments, mail, handles filing, faxing and photocopying. Other activities/projects as assigned including the preparation and distribution of computer reports in claims management system
- Performed data entry into internal systems to process claims requests.
- Provides back-up telephone support.
Customer Service Representative
Capital One
Irving, TX
05.2006 - 07.2007
- Provided account information and answered customer inquiries in a timely manner.
- Assisted customers with deposits, withdrawals, transfers, and other banking transactions.
- Resolved customer complaints or escalated them to the appropriate personnel as needed.
- Explained banking procedures and regulations to customers accurately.
- Maintained records of customer accounts including transactions and balances.
- Received telephone calls from customers regarding their accounts or services provided by the bank.
- Promoted available products and services to customers during service, account management and order calls.
Education
High School Diploma -
Justin F. Kimball
Dallas, TX05-2003
Some College (No Degree) - Business Administration and Management
Texas A&M University - Commerce
Commerce, TXSkills
- Customer service expert
- Professional telephone demeanor
- Inbound and Outbound Calling
- Coaching and Mentoring
- Critical Thinking
- Team Leadership and Coordination
- Team Communication and Collaboration
- Microsoft Outlook
- Microsoft Excel
- System implementation
- Problem-solving abilities
- Senior leadership support
- Medical terminology knowledge
- Administrative Support
Certification
- Certified Disability Management Employee Coalition
- Completion of Leadership Program Certification
Timeline
Team Coordinator
Sedgwick
02.2022 - 09.2024
Disability Representative I and II
Sedgwick
11.2010 - 02.2022
Service Center Representative Sr.
Sedgwick
03.2010 - 11.2010
Claims Assistant
Sedgwick
07.2007 - 03.2010
Customer Service Representative
Capital One
05.2006 - 07.2007
High School Diploma -
Justin F. Kimball
Some College (No Degree) - Business Administration and Management
Texas A&M University - Commerce
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