Shana Simms
Margate,USA
Summary
I bring a strong track record of solving problems, supporting people, and keeping things running smoothly behind the scenes. I’ve worked in fast paced environments where every call, claim, or case mattered and I learned how to handle pressure without losing focus. Whether guiding someone through their benefits, resolving fraud concerns, or leading a team, I stay clear, calm, and in control. I take pride in doing the job right the first time, learning quickly, and stepping in wherever I’m needed. It’s not just about getting it done, it’s about doing it well.
Overview
6
6
years of professional experience
Work History
Supervisor
Bank of America-North Lauderdale, FL
North Lauderdale, FL
03.2023 - 04.2025
- Led a team in identifying and analyzing potential fraud risks, conducting detailed investigations to ensure accurate risk assessments
- Supervised and supported the end-to-end fraud claims process, ensuring compliance with bank policies and regulatory standards
- Reviewed and approved claim decisions, account restrictions, and closures to mitigate fraud-related losses
- Maintained high levels of customer satisfaction while balancing risk exposure and operational efficiency
- Provided coaching and performance feedback to team members, ensuring adherence to KPIs and quality metrics
Customer Service Representative
Alight Solutions
01.2022 - 02.2023
- Processed and resolved employee insurance claims for medical, dental, vision, and disability benefits
- Reviewed policy coverage and claim eligibility according to employer-provided benefit plans
- Investigated and escalated complex claim issues to appropriate internal departments
- Provided high-volume phone and written support to employees regarding claim status, benefit details, and next steps
- Documented case notes thoroughly and maintained accurate claim records using internal systems
- Delivered clear and compliant resolutions while meeting performance and quality targets
Customer Service Representative
Florida Kid Care
08.2020 - 01.2023
- Handled high-volume inbound calls assisting applicants and members with healthcare applications
- Reviewed and verified documentation, calculated household income, and determined eligibility based on federal and state guidelines
- Provided guidance on plan selection, enrollment steps, and program requirements
- Accurately documented member interactions, updated accounts, and escalated complex cases to appropriate departments
- Ensured compliance with HIPAA and Florida Department of Health procedures while delivering empathetic and accurate service
Customer Service Representative
Global Response
Coral Springs, FL
01.2019 - 10.2020
- Delivered front-line support in a high-volume call center, assisting customers with product inquiries, orders, and account issues
- Resolved billing concerns, processed returns/exchanges, and tracked shipments across multiple systems
- Maintained strong product knowledge and brand standards while representing major retail and e-commerce clients
- Documented call details accurately and ensured timely follow-up and case resolution
- Met or exceeded performance goals in quality, call handling time, and customer satisfaction metrics
Education
Somerset Preparatory High School
Fort Lauderdale, FL2019
Skills
- Training and mentoring
- Goal oriented
- Staff management
- Customer service
- Attention to detail
- Complex Problem-solving
- Staff development
- Staff discipline
- Analytical thinking
- Team building
- Relationship building
- Project planning
- Coaching and mentoring
- Quality control
- Time management
- Multitasking
- Audit reporting
Languages
English
Native or Bilingual
Timeline
Supervisor
Bank of America-North Lauderdale, FL
03.2023 - 04.2025
Customer Service Representative
Alight Solutions
01.2022 - 02.2023
Customer Service Representative
Florida Kid Care
08.2020 - 01.2023
Customer Service Representative
Global Response
01.2019 - 10.2020
Somerset Preparatory High School