Shanika Williams

• Address member inquiries regarding claims, coordination of benefits, provider status, and complaints, ensuring clear and accurate information delivery on a one-call resolution.
• Facilitate effective communication between members and providers to resolve issues, and enhance customer satisfaction.
• Collaborated with cross-functional teams to identify customer needs and align services accordingly.
• Built personal relationships with guests to promote positive experiences.
• Utilized strong communication skills to effectively convey complex topics in a digestible manner to diverse audiences.

• Managed the resolution of warranty and service requests for high-end furniture, ensuring timely and effective complaint handling.
• Coordinated and scheduled technician services to address and resolve customer issues efficiently.
• Managed scheduling and logistics for client consultations, optimizing service delivery efficiency.
• Streamlined communication between departments, fostering collaboration and reducing response times.
• Analyzed customer service trends, identifying opportunities for process enhancements and operational efficiencies.

Conducted thorough investigations into potential fraudulent activities within healthcare transportation services.

• Analyzed complex data sets to identify patterns and anomalies indicative of fraud.
• Prepared detailed reports summarizing findings, ensuring compliance with regulatory standards and company policies.
• Maintained a high level of confidentiality when handling sensitive information, protecting both company reputation and client privacy.
• Conducted research and interviews with relevant stakeholders to gather evidence and build case files.

• Coached and monitored team members to enhance their performance and achieve key performance indicators (KPIs).
• Developed team members' skills through targeted training on essential tools and account management.
• Resolved conflicts between team members diplomatically, maintaining a healthy working environment conducive to productivity.
• Managed performance reviews for 15 employees, analyzing individual employee achievements, and overall trends in workforce execution metrics.
• Communicated policy updates and company information through team meetings, huddles and one-on-one development sessions.

• Managed high-volume calls, ensuring timely response and customer satisfaction.
• Resolved customer inquiries through effective communication and problem-solving techniques.
• Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
• Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.

• Resolved patient-responsible balances through verification of correct claim submission and post-insurance payment assessment.
• Offered tailored payment solutions, including full payments, structured payment plans, and settlement offers, to efficiently manage member balances.
• Engaged with patients to address and resolve outstanding financial obligations, ensuring clear communication and satisfaction.
• Managed time efficiently in order to complete all tasks within deadlines.
• Used critical thinking to break down problems, evaluate solutions and make decisions.