MARIANNE WILLIAMS
Gary,IN
Summary
Customer Service Representative Ⅱ with 2+ years of experience supporting Medicare and Medicaid members and assisting with grievance intake and appeal related inquiries. Experienced in benefits explanation, claim review, documentation, and compliance with CMS guidelines. Strong communicator with a consistent focus on empathy and accurate case documentation.
Overview
9
9
years of professional experience
Work History
Customer Service Representative ll
Humana
09.2023 - Current
- Reviewed and documented member complaints related to benefits, coverage, billing, and services in compliance with grievance guidelines.
- Educated members on the grievance and appeals process, including next steps, documentation requirements and timeliness.
- Entered detailed case notes and supporting information into CRM to ensure accurate tracking and timely resolution.
- Supported Medicare Advantage and Medicaid members with billing, coverage, pharmacy, and claim related inquiries.
- Collaborated with internal teams and external providers to obtain documentation for claim resolution.
Customer Service Representative
Kaotic Klaws
01.2019 - 09.2023
- Managed appointment schedules, customer payments, and orders.
- Resolved customer inquiries and concerns using effective communication skills.
- Provided professional nail services including manicures, pedicures, gel, and acrylic.
Customer Service Representative
Stericycle
06.2017 - 12.2018
- Provided product and service information to clients.
- Conducted outbound calls to members to collect, verify, or update information related to product recalls or patient communication.
Education
Bachelor of Science - Criminology
Indiana State University
Skills
- Grievance intake support
- Appeal related inquiries
- Timeliness and accuracy
- Prioritization
- Detail oriented
- Case documentation
- Benefit and claim review
- Medicare Advantage
- Medicaid
Timeline
Customer Service Representative ll
Humana
09.2023 - Current
Customer Service Representative
Kaotic Klaws
01.2019 - 09.2023
Customer Service Representative
Stericycle
06.2017 - 12.2018
Bachelor of Science - Criminology
Indiana State University