Summary
Overview
Work History
Education
Skills
Timeline
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Mariama Ibrahim

Dallas

Summary

Detail-oriented Customer Service Specialist with 8 years of experience in healthcare claims, case management support, and data accuracy. Skilled in triaging referrals, ensuring compliance with medical guidelines, and maintaining meticulous case documentation. Adept at cross-functional collaboration, insurance claim analysis, and process improvement in high-volume environments. Dedicated Client Service professional with 8 years of experience in client account management and customer relations, seeking a Client Service Coordinator role. Proven expertise in client onboarding, process improvement, and cross-functional collaboration to enhance client satisfaction and operational efficiency. Skilled in regulatory compliance, data analysis, and strategic contract renewals.

Overview

9
9
years of professional experience

Work History

Customer Service Specialist

United Healthcare
01.2021 - 01.2025
  • Triaged incoming case referrals, prioritizing high-dollar concerns for potential case management
  • Reviewed and processed medical claims, identifying discrepancies and escalating complex issues
  • Maintained accurate case documentation in internal case management systems, ensuring regulatory compliance
  • Assisted in Stop Loss notifications and collaborated with insurance providers to address claim disputes
  • Acted as the primary contact for client accounts, ensuring timely resolution of issues and providing ongoing support
  • Assisted with new client onboarding by maintaining accurate records and guiding clients through processes
  • Researched and validated healthcare claim denials, collaborating with teams to resolve discrepancies
  • Managed contract renewals by reviewing terms, identifying benefit trends, and ensuring compliance

Customer Service Team Lead

AT&T
06.2019 - 12.2021
  • Managed high-volume case inquiries, ensuring proper documentation and directing cases to appropriate teams
  • Conducted case prioritization assessments to improve service efficiency and response times
  • Trained staff on triage protocols and customer issue escalation procedures
  • Managed client accounts to ensure customer needs were consistently met in a fast-paced environment
  • Led a team in monitoring performance metrics, resulting in improved customer interactions and retention rates
  • Conducted training sessions and performance evaluations to enhance team efficiency and service quality

Customer Service Specialist

Walmart
06.2016 - 06.2019
  • Triaged incoming case referrals, prioritizing high-dollar concerns for potential case management
  • Reviewed and processed medical claims, identifying discrepancies and escalating complex issues
  • Maintained accurate case documentation in internal case management systems, ensuring regulatory compliance
  • Assisted in Stop Loss notifications and collaborated with insurance providers to address claim disputes
  • Delivered outstanding customer support by effectively addressing inquiries and ensuring the resolution of service issues
  • Contributed to process improvements aimed at enhancing both customer satisfaction and operational efficiency
  • Collaborated with team members to identify and implement strategies for streamlining service operations

Education

Bachelor of Arts - Psychology

Kent State University
Kent, OH
12.2022

Skills

  • Medical Case Triage & Referral Processing
  • Claims Review & Stop Loss Notification
  • ICD-10
  • CPT
  • HCPCS Coding Familiarity
  • Medical Terminology & Compliance
  • Case Management & Documentation
  • Microsoft Excel
  • Microsoft Word
  • Microsoft Outlook
  • UM Web
  • El Dorado
  • Client Onboarding & Account Management
  • Customer & Provider Relations
  • Process Improvement & Data Analysis
  • Regulatory Compliance & Documentation
  • Health Insurance & Employee Benefits Knowledge
  • Contract Renewals & Strategy
  • Cross-Functional Collaboration
  • Strong Written & Verbal Communication

Timeline

Customer Service Specialist

United Healthcare
01.2021 - 01.2025

Customer Service Team Lead

AT&T
06.2019 - 12.2021

Customer Service Specialist

Walmart
06.2016 - 06.2019

Bachelor of Arts - Psychology

Kent State University

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Mariama Ibrahim