LAKISHA RAMSEY
Brownsburg,IN
Summary
Customer Service Professional experienced in Insurance industry. Achieved customer satisfaction and contributed to company success through relationship building and process optimization. Focused on delivering quality service while effectively managing insurance verification and documentation.
Overview
2
2
years of post-secondary education
11
11
years of professional experience
Work History
Resolution Specialist
Optum
03.2023 - Current
- Documented case notes and resolution steps in Optum customer records
- Identified root causes of customer concerns, tracked resolution process steps, and documented all actions taken.
- Tracked resolution status and followed up on outstanding account actions
- Escalated complex cases to specialized departments for further review
- Researched complex customer service requests involving multiple departments and personnel within the organization.
- Maintained up-to-date knowledge on company products, services as well as relevant industry regulations impacting service delivery standards, requirements.
- Provided feedback on processes used by other departments that could impact the overall satisfaction of customers.
Resolution Specialist
Optum
Eden Prairie, Minnesota
03.2023 - Current
- Resolve member inquiries using Optum claims and benefits systems
- Explain coverage details and resolution options to members and providers
- Review claim disputes and corrected records for accurate processing
- Processed member plan cancellations, maintaining compliance with company policies to safeguard member interests.
- Updated and recorded member demographic information in a database, enhancing data accuracy for improved service delivery.
Insurance Administration
United Health Group
Indianapolis, IN
11.2018 - 03.2023
- Managed high volume of daily calls, maintaining composure under pressure to deliver exceptional service.
- Documented calls and complaints in call center's CRM database for accurate tracking and resolution.
- Managed a high volume of calls daily, maintaining composure under pressure while providing exceptional service.
- Collaborated with other departments to ensure seamless support for customers across multiple areas.
- Documented detailed calls and complaints using call center's CRM database.
- Collaborated with departments to ensure seamless support for customers across multiple areas.
- Engaged in training to improve product understanding and service quality, continuously enhancing product knowledge and customer service skills.
Claims Processor
GEICO, Government Employees Insurance
Carmel, IN
10.2017 - 11.2018
- Improved customer satisfaction through timely communication, empathy, and clear explanations of claim outcomes.
- Established strong working relationships with external partners, including adjusters, legal counsel, and medical professionals, to streamline claim resolution processes.
- Minimized claim processing errors by conducting thorough investigations and accurately interpreting policy details.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Maintained confidentiality of patient finances, records, and health statuses.
Unit Patient Care Technician
I U West Hospital
Avon, Indiana
01.2016 - 10.2017
- Contributed to team collaboration by effectively communicating with nurses, doctors, and other healthcare professionals regarding patient needs.
- Assisted nursing staff with daily tasks to improve workflow.
- Obtained patient vital signs and reported results to staff nurses or physician, noting changes from prior measurements.
- Monitored vital signs and reported changes to clinical staff.
- Monitored, tracked, and communicated critical patient information to healthcare staff to support effective treatment planning and care delivery.
- Provided personal care for patients in a hospital setting by providing personal assistance and ambulating.
- Collected specimens and delivered samples to hospital laboratories.
Education
High School Diploma -
Benton Harbor High School
Benton Harbor, MISome College (No Degree) - Nursing
Brown Mackie College
Indianapolis, IN 04.2014 - 12.2015
Skills
- HIPAA trained
- Insurance verification
- Medical terminology
- Electronic records
- Data Entry Accuracy
- Effectively managed phone, email and or chat online workflow
- Microsoft Office proficiency
- Customer service
- Problem solving
- Organizational skills
- Remote Collaboration
- Self motivated
Timeline
Resolution Specialist
Optum
03.2023 - Current
Resolution Specialist
Optum
03.2023 - Current
Insurance Administration
United Health Group
11.2018 - 03.2023
Claims Processor
GEICO, Government Employees Insurance
10.2017 - 11.2018
Unit Patient Care Technician
I U West Hospital
01.2016 - 10.2017
Some College (No Degree) - Nursing
Brown Mackie College
04.2014 - 12.2015
High School Diploma -
Benton Harbor High School