Keuandra Williams
Orlando
Summary
A knowledgeable, motivated, and dedicated customer experience and medical claims specialist seeking a rewarding career opportunity. Possesses a strong work ethic centered on performance, and dedication to customer satisfaction. Consistently fulfills needs, and completes assignments effectively. Handles stressful situations with poise, and adjusts swiftly to new challenges. The objective centers on obtaining a stable, impactful role that utilizes skills and experience to drive growth and development for organizations, families, and individuals. I am an enthusiastic collaborator seeking organizations that provide avenues for personal and professional growth.
Overview
6
6
years of professional experience
Work History
Customer Service Representative II
Employers Preferred Insurance
Maitland
04.2023 - 08.2025
- Provided customer service by responding to inquiries, resolving complaints, and addressing issues in a timely manner.
- Collaborated with other departments to resolve issues during manufacturing operations.
- Support business owners in submitting new claims for on-site incidents.
- Inform owners of any payment challenges associated with worker's compensation policy.
- Enhanced customer service by supporting owners in conducting annual audit procedures
- Coordinated with claims adjusters regarding prior authorizations needed for medical visits
- Handle business correspondence by addressing email inquiries for claims and policy document requests.
- Supported onboarding process by instructing new hires on worker's compensation policies.
Customer Service Representative
CVS Caremark
07.2020 - 12.2022
- Reviewed and collected medical claims for medications, procedures, and specialty appointments requiring authorization.
- Processed insurance claims to ensure accuracy, timeliness, and compliance with established guidelines.
- Communicate with providers, patients, and insurance payers for clarification while partnering to address any discrepancies or denials.
Customer Experience Associate
Conduent
12.2019 - 07.2020
- Facilitated medication refills for care members, enhancing adherence to treatment plans.
Calculated medication cost estimates to support budget planning and patient affordability. - Process insurance verification, appeals, and coverage redeterminations for medications denied to members.
- Inform members about in-network pharmacies providing the lowest costs, along with available benefits.
- Coordinating daily medication refill processes and delivering medication estimate services to members.
- Addressing member escalations regarding medication, pricing, and enrollment plan sign-ups.
- Providing support for representatives/members struggling with coverage determination.
- Resolving Tier One Representative issues to ensure accurate information is provided to members, and adequate member support.
- Guide new hire class in training and development by implementing call shadowing, conducting calibrations, managing escalation calls, and delivering information support.
Education
Some College (No Degree) - Healthcare
South University
Savannah, GAHigh school Diploma -
Olympia Highschool
Orlando, FL05-2004
Skills
- HIPAA compliance
- Insurance and coverage verification
- Claims administration
- Microsoft software skilled
- Data entry
- Effective time management
- Training and development
- Communication
- Problem solving
- Organization
- Adaptable
- Issue resolution
- Cross-department collaboration
- Policy interpretation
- Technical support
- Multi-line phone talent
- Customer education
- Assertiveness
- Positive and professional
- Email correspondence
- Customer support
References
Conduent- Coworker
Jashawta Black
Jashawta@gmail.com
407-952-4102
Timeline
Customer Service Representative II
Employers Preferred Insurance
04.2023 - 08.2025
Customer Service Representative
CVS Caremark
07.2020 - 12.2022
Customer Experience Associate
Conduent
12.2019 - 07.2020
Some College (No Degree) - Healthcare
South University
High school Diploma -
Olympia Highschool
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