Mahalia Davidson
Garland
Summary
Experienced professional with 9 years of customer service expertise, including 7 years in call center environments and CRM software management. Strong technical support and research abilities with a detail-oriented approach to problem-solving and client relations skills. Authorized to work in the US for any employer.
Overview
6
6
years of professional experience
Work History
Health Care Case Manager
Accenture LLC
09.2022 - 07.2025
- Company Overview: Customer advocacy group for state of Massachusetts insurance marketplace .
- Communicated with insurance carriers via email to resolve health and dental insurance issues within the marketplace.
- Investigated and resolved policy discrepancies, coverage concerns, and enrollment complications with QA accuracy of 90% or higher resolution.
- Made outbound calls to inform clients of case resolution and next steps.
- Handled occasional inbound calls to assist clients with inquiries and provide support.
- Ensured compliance with state and federal healthcare regulations while maintaining confidentiality.
- Reviewed applicable documents for ID proofing for Navigators.
- Documented case notes and actions per case.
- Resolved payment discrepancies.
- Resolved customer account tech issues per SOP.
- Resolved billing issues.
- Handled/ resolved health and dental claims issues. Quick TaT times
- Enrolled members into dental and health plans
- Troubleshoot website issues per member issue called in
Customer Service Representative
Chime Solutions / Cigna
Dallas
02.2019 - 08.2022
- Provided exceptional customer service by addressing inquiries and resolving issues related to health insurance policies, medications, and claims using SOPs for customer resolution.
- Assisted clients in understanding their coverage, benefits, and claim processes, ensuring clarity and satisfaction.
- Processed policy changes, claims, prior authorizations and medication refills efficiently while adhering to company guidelines.
- Spoke with pharmacies to facilitate timely resolution of complex customer issues.
- Maintained detailed records of customer interactions and transactions to ensure compliance and enhance service quality.
- Utilized CRM software to track and manage customer inquiries, resulting in improved response times and customer satisfaction rates.
- Educated clients on available health resources and tools to promote proactive healthcare management.
- Resolved complex insurance inquiries and claims efficiently, enhancing customer satisfaction and reducing average call handling time by 15% at Chime Solutions / Cigna.
- Assisted member with medication delivery orders
Education
High School Diploma -
Bryan Adams Leadership Academy
Skills
- HIPAA
- Research
- Quality assurance
- Customer advocacy
- Problem solving
- Medication reviews
- Microsoft
- CRM Software
- Case Management/ resolution
- Claims processing
- Technical Support
- Salesforce
- Customer service
- Call Center
- Data entry
- Jira
- Excel
- Word
- Team Microsoft
- Outlook
- Typing speed 40wpm
- Health care management
- Compliance
- SOPS
- Prior authorization
- On the job training completed
Timeline
Health Care Case Manager
Accenture LLC
09.2022 - 07.2025
Customer Service Representative
Chime Solutions / Cigna
02.2019 - 08.2022
High School Diploma -
Bryan Adams Leadership Academy