SHANNTAQWAYLA WILLIAMS
Tampa,FL
Summary
Experienced with handling customer interactions and resolving issues promptly. Utilizes communication and empathy to build strong customer relationships. Track record of maintaining high customer satisfaction and fostering loyalty.
Overview
9
9
years of professional experience
Work History
Prior Authorization Specialist
Cigna
11.2024 - Current
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Verified eligibility and compliance with authorization requirements for service providers.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Managed a high volume of incoming calls, maintaining professionalism while effectively addressing the needs of callers seeking assistance with prior authorizations.
- Supported healthcare providers by offering guidance on alternative treatment options when initial requests were denied.
Pharmacy Call Center Representative
Walgreens
10.2021 - 04.2023
- Reduced call wait times by efficiently triaging incoming calls, streamlining communication between pharmacy staff and patients.
- Demonstrated empathy and professionalism while handling sensitive patient information and concerns.
- Achieved high levels of customer satisfaction with timely follow-up on pending inquiries or escalations.
- Improved customer satisfaction by addressing and resolving complex pharmacy-related inquiries.
- Elevated overall department performance by actively participating in team meetings, sharing best practices, and offering constructive feedback when necessary.
- Assisted pharmacists in verifying medication orders, ensuring patient safety and proper drug utilization.
- Utilized various software applications proficiently for efficient case management and documentation purposes.
- Maintained up-to-date knowledge of product and service changes.
Pharmacy Customer Care Representative
Amazon Pharmacy
06.2019 - 10.2021
- Handle complex or escalated customer inquiries related to prescription orders, medication information, insurance processing, and billing issues.
- Provide detailed explanations on medication usage, potential side effects, and other pharmacy-related concerns.
- Assist customers in managing their prescriptions, including refills, renewals, and transfers between pharmacies.
- Resolve high-level customer complaints or issues, ensuring customer satisfaction and compliance with pharmacy regulations.
Medicare/Medicaid Healthcare Customer Coordinator (Hybrid)
FIS Global
08.2016 - 06.2019
- Respond to customer questions regarding Medicare and Medicaid benefits, eligibility, and coverage options. Assist customers in resolving issues related to billing, claims, and service coverage.
- Provide clear explanations of Medicare/Medicaid policies, benefits, and procedures. Help customers through the process of enrolling or re-enrolling in Medicare/Medicaid programs.
- Input customer information, claims data, and other relevant details into the company’s CRM or database systems
- Assist customers in navigating online Medicare/Medicaid portals or accessing digital services.
Education
Diploma -
Brandon High School
Skills
- Insurance Verification
- Claims
- HIPAA Compliance
- Eligibility Determination
- Prior authorization process
- Eligibility Verification
- Patient referrals
- Physician order verification
- Proficiency in: OnePA, CSP, Genesys Phonebook, Avaya, Workspace - Pega portal, Solo RX, Scheduling, ATMs Assessments, RxHOME, C-Agent, and OpsInsight
Timeline
Prior Authorization Specialist
Cigna
11.2024 - Current
Pharmacy Call Center Representative
Walgreens
10.2021 - 04.2023
Pharmacy Customer Care Representative
Amazon Pharmacy
06.2019 - 10.2021
Medicare/Medicaid Healthcare Customer Coordinator (Hybrid)
FIS Global
08.2016 - 06.2019
Diploma -
Brandon High School
Similar Profiles
Rudee FriarRudee Friar
Customer Service Representative at CignaCustomer Service Representative at Cigna
Tiffany LovatoTiffany Lovato
Customer Service Advocate at CignaCustomer Service Advocate at Cigna
Luis GilLuis Gil
Customer Service Representative at CignaCustomer Service Representative at Cigna
TIA WHITETIA WHITE
Senior Enrollment / Medical Billing Specialist at CignaSenior Enrollment / Medical Billing Specialist at Cigna
Andrew HarrisAndrew Harris
Cashier/Front End Service Clerk at PublixCashier/Front End Service Clerk at Publix