Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Quelyn Willis

Las Vegas,NV

Summary

Knowledgeable and dedicated customer service professional with extensive experience in the medical industry. Solid team player with outgoing, positive demeanor and proven skills in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality, speed and process optimization. Articulate, energetic and results-oriented with exemplary passion for developing relationships, cultivating partnerships and growing businesses. Detail-oriented individual with exceptional communication and project management skills. Proven ability to handle multiple tasks effectively and efficiently in fast-paced environments. Recognized for taking proactive approach to identifying and addressing issues, with focus on optimizing processes and supporting team objectives.

Overview

6
6
years of professional experience
1
1
Certification

Work History

Chat Representative

Anthem
10.2023 - Current
  • Provide real-time assistance to healthcare professionals on claims, appeals, and policy information via chat communication, addressing up to 50 inquiries daily
  • Maintain a high performance standard, consistently achieving a metrics goal of 86% in query resolution and customer satisfaction
  • Utilize a range of software tools, including Compass, Salesforce, and Live Engage, for database management and effective resolution of provider issues
  • Retrieve and verify medical records from EMR systems, such as Cisco, Facets, Maces, Nexgen, and Epic, to ensure accurate claims processing and appeals handling
  • Deliver comprehensive support for member services, including updating insurance information, filing grievances, and facilitating healthcare provider changes

Provider Services (CCR II)

Anthem
10.2020 - Current
  • Assisted providers with the resolution of claims and appeals, ensuring accurate and efficient communication via chat support
  • Enhanced provider satisfaction by delivering timely and knowledgeable assistance, contributing to improved service quality

CCR I

Anthem
01.2020 - 10.2020
  • Delivered customer support for provider services, effectively handling inquiries and resolving claims and appeals via chat
  • Assisted clients with accurate information and guidance, ensuring a streamlined communication process

Call Center Representative

RDI Connect
08.2018 - 10.2019
  • Managed high call volumes while providing exceptional customer support and maintaining professional composure.
  • Handled escalated calls professionally, effectively resolving complex issues and ensuring client satisfaction at all times.
  • Mastered multiple software systems for seamless navigation during calls, improving efficiency and reducing hold times for customers.
  • Enhanced customer satisfaction by efficiently addressing and resolving inquiries in a timely manner.
  • Established strong relationships with healthcare professionals, resulting in increased trust and credibility for the organization.
  • Assisted physicians with patient education efforts, providing resources and support as needed.
  • Assisted member and providers with submitting appeals and grievances.
  • Obtained additional documentation required for case review.
  • Researched and resolved written complaints submitted by consumers and physicians or providers.
  • Negotiated with insurance carriers to find mutually agreeable solutions for disputed claims, contributing to higher customer satisfaction levels.

Education

Medical Administration Assistant - Medical Administration

Houston Community College
Houston, TX
06.2015

Skills

  • Microsoft Office Software
  • Excel
  • Data Entry
  • Record Pulling
  • 2 years HEDIS experience
  • 2 years Risk Management experience
  • Epic
  • Banner
  • Salesforce
  • Time Management
  • Deadlines
  • Managerial
  • Training
  • Quick Typing
  • Multitasking
  • Customer service excellence
  • Active Listening
  • 5 years of remote work
  • Medical records management
  • 25 Years claims experience
  • 6 Years EMR experience
  • 25 Years call center experience
  • 3 years chat representative
  • 4 years working remotely

Certification

Medical Administration Assistant, Houston Community College, 01/01/15

Timeline

Chat Representative

Anthem
10.2023 - Current

Provider Services (CCR II)

Anthem
10.2020 - Current

CCR I

Anthem
01.2020 - 10.2020

Call Center Representative

RDI Connect
08.2018 - 10.2019

Medical Administration Assistant - Medical Administration

Houston Community College

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Quelyn Willis