Raynesha Williams
Miami,FL
Summary
Professional with comprehensive experience in claims processing and evaluation. Demonstrates strong analytical skills, thorough knowledge of insurance policies, and consistent track record of identifying and resolving complex claims. Valued team player with strong focus on collaboration and results, adaptable to evolving work environments. Known for reliability, problem-solving abilities, and effective communication with stakeholders.
Overview
6
6
years of professional experience
Work History
Claims Support Specialist
ResultsCX
Fort Lauderdale
02.2024 - 03.2025
- Improved claims processing efficiency by streamlining documentation and data entry procedures.
- Handled escalated issues from clients regarding their claims process, working collaboratively with relevant parties to resolve concerns quickly.
- Answer incoming calls from providers while assisting them with claim inquiries
- Filed appeals/grievances
- Escalated claim discrepancies to appropriate department
Benefits Specialist
The State of Florida
Miami
07.2021 - 12.2023
- Interviewed and investigated applicants for public assistance to gather information pertinent to applications.
- Scheduled benefits claimants for adjudication interviews to address questions of eligibility.
- Answered applicants' questions about benefits and claim procedures.
- Assisted applicants with obtaining program support or gaining assistance from outside services.
- Helped applicants understand requirements, application procedures and legal rights.
Healthcare Customer Service Representative
Teleperformance USA
Fort Lauderdale, FL
11.2020 - 06.2021
- Assisted in checking patient's insurance eligibility prior to their appointment.
- Resolved customer complaints while prioritizing customer satisfaction and loyalty.
- Exceeded team goals and collaborated with staff members to implement customer service initiatives.
- Processed payments and returns with accuracy and efficiency.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
Customer Service Representative
Sitel
Pompano Beach, FL
06.2019 - 06.2020
- Improved claims processing efficiency by streamlining documentation and data entry procedures.
- Handled escalated issues from clients regarding their claims process, working collaboratively with relevant parties to resolve concerns quickly.
- Answer incoming calls from providers while assisting them with claim inquiries
- Filed appeals/grievances
- Escalated claim discrepancies to appropriate department
Education
Technical Diploma - Medical Billing
Florida Technical College
Pembroke Pines, FL12-2025
Skills
- Data entry
- Effective communication skills
- Medical claims examiner
- Microsoft office
- Telephone etiquette
- HIPAA compliance
- Provider relations
- Medical billing and coding
- Eligibility assessment
- Benefits administration
Languages
English
Native or Bilingual
Spanish
Elementary
Timeline
Claims Support Specialist
ResultsCX
02.2024 - 03.2025
Benefits Specialist
The State of Florida
07.2021 - 12.2023
Healthcare Customer Service Representative
Teleperformance USA
11.2020 - 06.2021
Customer Service Representative
Sitel
06.2019 - 06.2020
Technical Diploma - Medical Billing
Florida Technical College