Shakayla Keyes
Huntsville
Summary
Committed to ensuring customer and/or patient satisfaction by providing exceptional service and unmatched support. Proficient in utilizing customer service best practices and adept at exploring different solutions to address needs effectively.
Overview
8
8
years of professional experience
Work History
Health Insurance Specialist
Caresource
12.2021 - Current
- Verified insurance coverage by telephone and online to guarantee proper reimbursement of benefits and estimate patients' financial responsibilities.
- Achieved high client retention rates by providing exceptional customer service and addressing concerns promptly.
- Answered inbound calls from existing and future policyholders to answer inquiries and discuss insurance options.
- Streamlined claim processing for quicker reimbursements, implementing a digital documentation system.
- Established trust with clients by accurately addressing their concerns and offering appropriate resolutions based on their needs.
Customer Service Representative
Blue Cross Blue Shield
02.2020 - 12.2021
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Answered constant flow of customer calls with numerous of calls in queue per minute.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Responded to customer requests for products, services and company information.
- Resolved complaints efficiently to satisfy customers and encourage future transactions.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
- Paid or denied medical claims based upon established claims processing criteria.
- Managed large volume of medical claims on daily basis.
- Collaborated with claims department and industry anti-fraud organizations to resolve claims.
Life Insurance Agent
Colonial Penn Life Insurance Company
03.2018 - 02.2020
- Provided coverage option information to assist clients in protecting assets.
- Attended continuing education courses and workshops to gain additional insurance industry knowledge.
- Determined financial needs by assessing existing coverage and aligning new products and services with long-term goals.
- Maintained high standards of customer service by building relationships with clients.
- Provided exceptional customer service by addressing concerns promptly and maintaining open lines of communication.
- Participated in professional development opportunities such as training sessions and conferences to stay informed on best practices within the life insurance industry.
Customer Service Representative
Caresource Health Plan
05.2016 - 04.2018
- Evaluated customer information to explore issues, develop potential solutions and maintain high-quality service.
- Learned all internal systems and related service role duties to provide skilled team backup in handling customer demands.
- Completed training and worked effectively under high-pressure client services environments.
- Continuously surpassed customer service standards while ensuring compliance with call volume objectives.
- Maintained clean, organized and well-stocked member service area.
- Assessed caller accounts to determine health benefits, identify service needs and resolve issues.
- Managed high call volumes while providing exceptional customer support and maintaining professional composure.
Education
Certification - Medcial Assisting
Virginia College - Birmingham
Birmingham, ALSkills
- HIPAA Compliance
- Healthcare knowledge
- Insurance regulations
●Multi-line phone operation proficiency
● Committed to Committed to maintaining data integrity
● MS Windows proficient
● Medical terminology
● Electronic medical records
● Local/state health laws knowledge
● CPR/First Aid certified
● Insurance claims
● Health insurance
● Policy renewals
● Claims reporting systems
- Vital signs monitoring
- Patient Observation
● Skilled in call center operations
● Persuasive speaker
● Facets
● Diagnostic codes
● Triage
● Interpreting laboratory results
● HIPAA compliance
● Phlebotomy
● Insurance sales expertise
● Life insurance
● Quotes and sales
● Client needs analysis
Timeline
Health Insurance Specialist
Caresource
12.2021 - Current
Customer Service Representative
Blue Cross Blue Shield
02.2020 - 12.2021
Life Insurance Agent
Colonial Penn Life Insurance Company
03.2018 - 02.2020
Customer Service Representative
Caresource Health Plan
05.2016 - 04.2018
Certification - Medcial Assisting
Virginia College - Birmingham
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