Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Shammorria C. Showers

Brandon,MS

Summary

Motivated and customer-focused professional with a strong background in customer service and proven ability to resolve customer issues efficiently and effectively. Skilled at communication, problem-solving, and collaborating with teams to achieve performance goals. Adaptable and solution-oriented, with a focus on delivering exceptional customer experiences.

Overview

13
13
years of professional experience
1
1
Certification

Work History

Appeals & Grievance Specialist

Broadpath (contract)
10.2023 - Current
  • Enters denials and requests for appeal into information system and prepares documentation for further review..
  • Research issues utilizing systems and other available resources.
  • Assures timeliness and appropriateness of appeals according to state and federal and Molina Healthcare guidelines.
  • Requests and obtains medical records, notes, and/or detailed bills as appropriate to assist with research.
  • Determines appropriate language for letters and prepares responses to appeal and grievances.
  • Elevates appropriate appeals to the Seasonal Appeals Specialist.
  • Generates and mails denial letters.
  • Assists with interdepartmental issues to help coordinate problem solving in an efficient and timely manner.
  • Creates and or maintains statistics and reporting.
  • Works with provider & member services to resolve balance bill issues and other member/provider complaints.

Customer Service Representative

CareCentrix
06.2020 - 08.2023
  • Collaborated with cross-functional teams to streamline processes and improve service delivery effectiveness.
  • Provided product knowledge and technical support to customers, enhancing user experience and trust in services.
  • Resolved customer inquiries efficiently through multiple communication channels, ensuring satisfaction and retention.
  • Analyzed customer feedback data to identify trends, driving enhancements in service protocols and policies.
  • Responded to customer requests for products, services, and company information.
  • Managed high call volumes, ensuring timely and accurate responses to customer inquiries.
  • Resolved complex customer issues by utilizing problem-solving techniques and product knowledge.

Certified Nursing Assistant

Willow Creek Rehab
08.2012 - 05.2020
  • Assist patients with activities of daily living (ADLs), such as bathing, dressing, grooming, and feeding.
  • Help patients with mobility by turning, repositioning, and transferring them between beds, wheelchairs, or stretchers.
  • Take and record vital signs, including temperature, blood pressure, pulse, and respiration.
  • Monitor patient condition and report changes to nurses or medical staff.
  • Provide basic patient care, such as changing bed linens, cleaning rooms, and ensuring a safe environment.

Education

High School Diploma or Equivalent -

Crystal Springs High School
Crystal Springs, MS
01.2012

Skills

  • Customer Service Excellence
  • Strong Verbal & Written Communication
  • Problem-Solving & Critical Thinking
  • Organizational & Time Management
  • Collaboration & Teamwork
  • Windows-Based Systems & Data Entry (25 WPM)
  • Adaptability & Open-Mindedness
  • Sales & Up-selling (Preferred Experience)
  • Patient Care & Compassion
  • Knowledge of Medical Terminology
  • Vital Signs Monitoring
  • Activities of Daily Living (ADL) Assistance
  • Infection Control & Safety Procedures
  • Teamwork & Collaboration with Nurses and Doctors
  • Effective Communication (with patients, families, and staff)
  • Time Management & Organization
  • Mobility Assistance (lifting, transferring, and repositioning)

Certification

  • Customer Service Training Certificate
  • Microsoft Office/Computer Skills Certification
  • Certified Nursing Assistant
  • CPR/BLS

Timeline

Appeals & Grievance Specialist

Broadpath (contract)
10.2023 - Current

Customer Service Representative

CareCentrix
06.2020 - 08.2023

Certified Nursing Assistant

Willow Creek Rehab
08.2012 - 05.2020

High School Diploma or Equivalent -

Crystal Springs High School

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