Summary
Overview
Work History
Education
Skills
Timeline
Generic

Khadija Washington

Ridgeville,SC

Summary

Customer Service Representative bringing top-notch skills in oral and written communication, active listening and analytical problem-solving skills. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires and providing customized solutions to build loyalty. Highly trained professional with a background in verifying insurance benefits and creating appropriate patient documentation. An established Insurance Verification Specialist known for handling various office tasks with undeniable ease. Tactful Claims Specialist with expertise in settlement preparation, claims processing and appeal filing. Diplomatic and personable professional accustomed to handling sensitive, confidential information and investigating complex liability claims. Committed to maintaining customer satisfaction and contributing to company success. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level Job Title position. Ready to help team achieve company goals. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.

Overview

10
10
years of professional experience

Work History

Fraud Claim Specialist

MRA
03.2023 - 02.2024
  • Processed and recorded new policies and claims.
  • Verified client information by analyzing existing evidence on file.
  • Monitored compliance with regulations and industry best practices to promote fair and proper treatment for insured customers.
  • Generated, posted and attached information to claim files.
  • Managed high-volume caseloads effectively, prioritizing urgent cases while maintaining attention to detail for all claims.
  • Identified fraudulent activity through meticulous analysis of claim data, protecting company resources from potential losses.
  • Reduced claim processing time by implementing efficient workflow procedures and organization systems.
  • Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
  • Learned and adapted quickly to new technology and software applications.
  • Demonstrated strong organizational and time management skills while managing multiple projects.
  • Managed time efficiently in order to complete all tasks within deadlines.

Healthcare Customer Service Representative

TTEC
09.2022 - 03.2023
  • Enhanced patient satisfaction by efficiently addressing and resolving healthcare-related inquiries.
  • Boosted customer retention by promptly handling complaints and providing appropriate solutions.
  • Expedited service times with effective triage of incoming calls, directing patients to the correct department or resource.
  • Facilitated smooth communication between patients, insurance companies, and medical staff for seamless coordination of care.
  • Implemented and developed customer service training processes.
  • Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
  • Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
  • Met customer call guidelines for service levels, handle time and productivity.
  • Promoted superior experience by addressing customer concerns, demonstrating empathy, and resolving problems swiftly.
  • Educated customers about billing, payment processing and support policies and procedures.
  • Increased first-call resolution rates by carefully listening to customers'' needs and providing accurate information based on their inquiries.
  • Promptly responded to inquiries and requests from prospective customers.
  • Stayed calm under pressure to and successfully dealt with difficult situations.

Customer Service Representative

Alorica
10.2021 - 08.2022
  • Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
  • Streamlined call center processes for improved efficiency and reduced wait times.
  • Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
  • Assisted customers in navigating company website and placing online orders, improving overall user experience.
  • Updated account information to maintain customer records.
  • Educated customers about billing, payment processing and support policies and procedures.
  • Provided excellent customer care by responding to requests, assisting with product selection and handling ordering functions.
  • Answered customer telephone calls promptly to avoid on-hold wait times.
  • Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
  • Promptly responded to inquiries and requests from prospective customers.
  • Handled customer inquiries and suggestions courteously and professionally.
  • Responded to customer requests, offering excellent support and tailored recommendations to address needs.
  • Investigated and resolved customer inquiries and complaints quickly.

Shift Manager

KFC Restaurant
02.2014 - 02.2021
  • Improved overall team performance by effectively delegating tasks and providing clear instructions.
  • Achieved consistent customer satisfaction by addressing concerns promptly and professionally.
  • Managed employee schedules to ensure adequate coverage during peak hours, resulting in a smoother workflow.
  • Promoted a positive work environment through open communication and constructive feedback.
  • Developed strong relationships with vendors to ensure timely delivery of products while maintaining cost efficiencies.
  • Handled emergency situations with a calm demeanor, ensuring the safety of both customers and employees during critical incidents.
  • Supervised ongoing daily production phases.
  • Monitored daily and weekly key performance indicators to maintain on-track status.
  • Trained new employees on company policies, procedures, and job responsibilities, ensuring seamless integration into the team.

Education

Associate of Science - Nursing

Trident Technical College
Charleston, SC
2021

High School Diploma -

Woodland High School
Dorchester, SC
2013

Skills

  • Customer Service
  • Inbound and Outbound Calling
  • Microsoft Office Suite Expertise
  • Data Entry and Analysis
  • Time Management
  • Extensive experience in claims management and adjusting
  • Exceptional knowledge of insurance contracts coverages claims management programs and all related medical and legal terminology
  • Superior ability to interpret and review account statements and histories
  • Strong grasp of a variety of claim processing rules and guidelines
  • Excellent skills in analyzing legal documents and medical records
  • High problem-solving and organizational skills
  • Proven ability to self-motivate and work independently
  • Solid written and oral communication skills
  • Efficient & Detailed-oriented
  • Zendesk
  • Creative problem solving
  • Empathy
  • Claims Processing
  • Attention to Detail
  • Complex Problem-Solving
  • Typing Proficiency (50 WPM)
  • Legal Compliance
  • Collaborative Environments
  • Organization
  • Confidentiality and regulatory compliance
  • Data entry procedures and standards development
  • Cross-functional collaboration
  • Troubleshooting and error resolution
  • Financial Transactions
  • Relationship Building
  • Document Control
  • Multitasking
  • Data Evaluation

Timeline

Fraud Claim Specialist

MRA
03.2023 - 02.2024

Healthcare Customer Service Representative

TTEC
09.2022 - 03.2023

Customer Service Representative

Alorica
10.2021 - 08.2022

Shift Manager

KFC Restaurant
02.2014 - 02.2021

Associate of Science - Nursing

Trident Technical College

High School Diploma -

Woodland High School
Khadija Washington