Mashanna Freeman
Tampa
Summary
Senior Escalation Specialist with 4 years of experience in resolving complex, high-priority complaints from members and providers. Proven ability to act as a liaison between departments to implement enterprise-wide solutions. Skilled in root cause analysis, tracking, and documentation, with a focus on reducing future escalations and enhancing overall service satisfaction.Qualified Member Services Representative with many years in fast-paced customer service and call center environments. Personable and professional under pressure.
Overview
7
7
years of professional experience
Work History
Senior Intake Member Services Representatives
Women’s care
Tampa
02.2022 - Current
- Assisted with high-priority member and provider complaints, providing timely and appropriate resolutions via telephone and written channels.
- Assisted members with inquiries regarding services and benefits.
- Served as a key liaison between claims, billing, and clinical departments to resolve complex, cross-functional issues.
- Performed root cause analysis on escalated inquiries to identify trends, working with management to develop actionable recommendations for process improvements.
- Researched and identified claims payment errors, making necessary adjustments to resolve provider disputes efficiently.
- Documented, tracked, and updated all assigned cases in the system with 100% accuracy to ensure compliance with company policies and CMS standards.
- Coordinated with contact center team to validate complaints and evaluate remedial options.
Customer Service Representative
Blue cross blue shield
Tampa
03.2019 - 02.2022
- Handled high-volume inbound calls and correspondence from providers, offering prompt guidance on claims, benefits, and authorization processes.
- Reduced repeat complaints by 15% through proactive identification of underlying facts during inquiry research.
- Developed strong knowledge of products and services to provide accurate and effective support.
- Explain benefits, managed care contracts, and compliance requirements to customers clearly.
- Report operational challenges to management for timely resolution and service improvement.
- Assisted customers with inquiries regarding health insurance plans and benefits.
- Processed claims and ensured accurate documentation for timely resolutions.
- Educated members on policy coverage and eligibility requirements effectively.
Education
Bower Whitley Career Center
Tampa, FLSkills
- Escalation management
- Problem tickets
- First call solution
- Communication Services
- Empathy conflict
- Written/telephone solution
- Documentation
- Date entry
- Team collaboration
References
References available upon request.
Timeline
Senior Intake Member Services Representatives
Women’s care
02.2022 - Current
Customer Service Representative
Blue cross blue shield
03.2019 - 02.2022
Bower Whitley Career Center