Shanise Mahomes
Chicago,IL
Summary
Support day-to-day program operations with expertise in records management and resource coordination. Skillfully meet diverse needs and address issues to maintain efficiency and program outreach. Demonstrated success in building long-lasting relationships.
Resourceful and dedicated with excellent communication and relationship-building skills. Knowledgeable about health providers, procedures and plan benefits. Helps customers complete enrollments while minimizing stress and maximizing satisfaction with process and company.
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
12
12
years of professional experience
Work History
Application Support Specialist
Deinde Financial/Integra Credit
Chicago, IL
01.2024 - Current
Benefits Support Advocate (Health Concierge)
Bswift/ IG
Chicago
09.2023 - 01.2024
- Answer incoming calls and chats from customers about their employer's benefits plans
- Accurately completing phone enrollments
- Provide accurate benefit information to caller's in a timely manner
- Collects information to authenticate calls
- Educate and advise callers on their benefits, the system, and all related processes
- Assist callers with password resets
- Process enrollment related transactions
- Document information into clients system to track customer interactions and solutions
- Creates cases for new callers and log information
- Check cases created and statuses per caller's request
- Look up dependent verification documents
- Provide vendor contact information upon request
- Explain to caller's in detail about health insurance plans available to them for coming plan year.
- Handled more than 75 daily inbound calls from health plan customers.
Customer Service Representative
Insight Global
Chicago
02.2021 - 12.2022
- Managed client records
- Set up client appointments
- Answered general questions
- Responded to claim inquiries
- Resolved customer complaints
- Am able to navigate multiple technologies while staying engaged with our customers
- Responsible for tracking and monitoring illegal filed claims on accounts without the authorization of the claim owner
- Converse directly with customers to resolve issues
- Worked in multiple departments to meet companies needs
- Processed protest on behalf of claimants or employers
- Indexed documents and placed them in claimants Ecf Folders according to Identity Verification Documents
- Filed certifications for claimants
- Added and updated personal information for claimants
- Verified claimants through personal information in systems
- Processed Fraud reports through excel sheets via email
- Resent payment details to claimants when requested
- Transferred calls to appropriate departments for further assistance when needed.
Call Center Customer Service Representative
Nan Mckay/Chicago Housing Authority
02.2020 - 02.2021
- Handle all customer contacts by phone accurately and professionally
- Respond to all customer's inquiries and probe accordingly as to provide a first contact resolution
- Adhere to regular attendance and punctuality
- Accurately and thoroughly record call log notations in the system for records
- Researched required information using available resources and knowledge
- Defuse and deescalate irate customers as to ensure a great customer experience
- Verify and update customer information
- Perform data entry into SharePoint and PHA business systems
- Identify and escalate emergency/priority calls
- Obtain certification in Housing Choice Voucher Basics within 120 days of employment at 70 percent.
Customer Service Representative (Contract Role)
Olin Chlor Alkali Products
Downers Grove
04.2019 - 02.2020
- Process Orders, handle routine and non-routine customer order management activities, including managing customer demand, following up on samples, complex order entry (i.e
- Consignment) guiding and leading activities of order process utilizing work process, business strategy, and best practice
- Identifying and predict how events and trends are likely to affect customer's future needs
- Perform System requirements by executing work process through multiple systems and technology including: SAP, Rail Fleet System, Polemical, Telemetry, and Rail tools
- Provide product availability, specifications and schedule information within established guidelines
- Adjusts freight pricing and utilize ship points and package size as well as logistic improvements
- Serve as liaison between customers, logistics, sales, quality, technical services and accounting to assure responsiveness
- Tracks order activity and alerts appropriate staff of any potential delivery problems
- Expedite delivery of selected orders
- Research and obtain resolution of variety of customer complaints, resolves issues and communicates outcomes as defined by customer service procedures
- Processes daily shipments (rail, truck, barge)
- Support accounting as needed with investigating payment discrepancies while bringing accounts up to date as defined by customer service standard operating procedures
- Maintain detailed records related OR&H and perfect shipment regarding customer service activities in accordance with the company's record retention policy
- Prepare reports specific to customer needs in accordance with company policies, customer service procedures and submits by required deadlines
- Maintain relationships with sales force and technical services to understand their requirements and priorities relating to customer needs
- Maintain working knowledge of company's products, current plant production and shipping capabilities.
Client Account Coordinator Assistant Manager (Contract Role)
Kelly Services/Blue Cross Blue Shield of IL
Downers Grove
09.2018 - 02.2019
- Support current customers and potential new business customers
- Input new account information and resolve customer issues/problems
- Serves as a contact point, processes new accounts and renewals for assigned accounts and assists in resolving any onboarding problems
- Provide administrative service for individual members and group accounts via phone and email
- Provide product information and application assistance for groups and individual members
- Completed quotes using Xactimate software for small business to complete insurance plans
- Provides information and booklets to members and assists internal staff in communicating contract changes, underwriting policies and billing procedures to employers, group leaders, consultants, agents, brokers and employees
- Tracks correspondence for member situations and department research
- Completed quotes while using Xactimate software
- Complete, review and processes group and individual paperwork
- Follows-up for additional information, as needed
- Researches and resolves benefits, billing and/or claims issues
- Assists group accounts on processes and claims filing requirements
- Serves as a contact point, processes new accounts and renewals for assigned accounts and assists in resolving any onboarding problems
- Request renewal rates, rate codes, Summary of Benefits and Coverage (SBC), grids, cards and forms
- Completes routine and complex transmittals, mailings and notifications as well as develops new proposals and renewal options for existing groups
- Assists in the sale of individual products including health insurance, supplemental insurance, dental, travel and ancillary products to new and existing clients.
Customer Service Representative
Go Health
Chicago
11.2017 - 01.2018
- Multi-task in a fast-paced environment handling large call volumes, emails, faxes, and paperwork with accuracy and speed
- Enroll eligible clients in Medicare Advantage Plans
- Obtain, review and input insurance authorization and patient referrals
- Resolve client issues, collaborate with other departments to ensure all programs run efficient and timely
- Assist clients with adding/deleting dependents with Medicare advantage plans
- Processed patient payments through Epic systems
- Manage and assist with plan transitions and insurance renewals
- Assisted with medical billing for patients through insurance
- Assist current and potential plan members with updated Medicare Advantage Plan options
- Assist and collaborate with managers with onboarding and training new hires
- Maintain/schedule home visits for current members seeking care with plan benefit advisor
- Document, update, respond and provide resolutions to all calls and issues in the CRM system
- Screen patients to determine eligibility for Medicare Advantage Plan
- Manage current and potential member accounts regarding current changes with Illinois Medicare plans
- Provide step by step information/assistance in patient application and Medicare Advantage Plan process.
Customer Service Representative
Informis Health Solutions
Chicago
10.2012 - 06.2014
- Provide general information to customers regarding Medicare Advantage (MA, MA-PD) and Prescription Drug plans (PDP)
- Accurately completing phone enrollments
- Provide accurate, knowledgeable responses to inbound/outbound customer inquiries in a courteous and timely manner
- Maintain a current understanding of processing procedures and use that knowledge to effectively respond to and document phone inquiries
- Provide plan benefit information, scheduling appointments and completing enrollments
- Processed patient payments through Epic systems
- Answer inbound calls from members and assist with inquiries regarding Medicare plans
- Assisted with medical billing for patients through insurance
- Assist members with plan benefits and/or make referral to licensed insurance agents
- Manage calendar(s) for numerous insurance agents
- Document members issues and additional member data
- Provide resolutions, validate member demographic information
- Advise and enroll Medicare eligible recipients into Medicare Supplement and Advantage Plans.
Education
High school diploma - Business Management
John Marshall High School
Chicago, IL03.2006
No Degree - Business Management
Morton College
Cicero, ILSkills
- Customer Service
- Customer Care
- Call Center
- CSR
- Client Service
- HUD MANAGEMENT SOFTWARE
- SAP
- Order Entry
- CRM Software
- Microsoft SharePoint
- Office Management
- Calendar Management
- Section 8
- Fair Housing Regulations
- Yardi
- Case Management
- HIPAA
- Logistics
- Research
- Epic (2years)
- Application support
- Customer Support
Timeline
Application Support Specialist
Deinde Financial/Integra Credit
01.2024 - Current
Benefits Support Advocate (Health Concierge)
Bswift/ IG
09.2023 - 01.2024
Customer Service Representative
Insight Global
02.2021 - 12.2022
Call Center Customer Service Representative
Nan Mckay/Chicago Housing Authority
02.2020 - 02.2021
Customer Service Representative (Contract Role)
Olin Chlor Alkali Products
04.2019 - 02.2020
Client Account Coordinator Assistant Manager (Contract Role)
Kelly Services/Blue Cross Blue Shield of IL
09.2018 - 02.2019
Customer Service Representative
Go Health
11.2017 - 01.2018
Customer Service Representative
Informis Health Solutions
10.2012 - 06.2014
High school diploma - Business Management
John Marshall High School
No Degree - Business Management
Morton College
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