Shaquanda Sims
Columbus,GA
Summary
Seeking Associate VB Claims Specialist role with 8 years of customer service experience in insurance and healthcare settings. Skilled in explaining complex benefits, maintaining high customer satisfaction, and adhering to HIPAA standards. Proven track record in problem resolution, customer education, and team collaboration.
Overview
9
9
years of professional experience
Work History
Customer Benefit Advisor
Colonial Life & Accidental Insurance
Columbia, SC
07.2022 - Current
- Educate plan participants on benefit options using clear and comprehensible language to ensure thorough understanding
- Implement proactive strategies to maintain high levels of customer satisfaction, effectively addressing needs and resolving issues
- Respond to customer inquiries, providing detailed information about products and services while meeting established call-time and quality benchmarks
- Analyze trends in customer service to identify improvement opportunities, contributing valuable feedback for enhancing service delivery.
Patient Access Representative
OGYN Physician Partners
Columbus, GA
06.2021 - 07.2022
- Ensured accurate insurance billing by identifying and sequencing payment sources, facilitating effective claims processing
- Maintained strict confidentiality of medical records and patient information, adhering to HIPAA regulations to safeguard privacy
- Managed patient financial transactions, including collection of deductibles and co-pays, and communicated available payment options for outstanding balances.
Customer Service Specialist
Aflac
Columbus, GA
08.2018 - 01.2021
- Resolved customer inquiries and complaints, ensuring adherence to company policies while fostering a positive work atmosphere
- Implemented customer service enhancements that reduced wait times and improved the efficiency of call handling processes
- Delivered exemplary support to both internal and external clients, achieving a high customer satisfaction rating through effective resolution of issues on the first call.
Customer Service Representative
TSYS
Columbus, GA
08.2015 - 08.2018
- Addressed customer inquiries and provided information on products and services, ensuring swift resolution of concerns to maintain satisfaction levels
- Delivered comprehensive training to new hires on operational practices, company policies, and service offerings to foster a knowledgeable support team
- Worked collaboratively with colleagues to improve the customer service process, contributing to the achievement of team objectives and high client satisfaction ratings.
Education
High School Diploma -
Dothan High School
Dothan, AL06.2008
Skills
- Compliance Knowledge
- Claims Handling
- Benefits Administration
- Policy Interpretation
- Dispute Resolution
- Benefits Explanation
- Relationship Building
- Written and Oral Communication
- Data Collection
- Data Entry
- Critical Thinking
- Problem-Solving Abilities
Timeline
Customer Benefit Advisor
Colonial Life & Accidental Insurance
07.2022 - Current
Patient Access Representative
OGYN Physician Partners
06.2021 - 07.2022
Customer Service Specialist
Aflac
08.2018 - 01.2021
Customer Service Representative
TSYS
08.2015 - 08.2018
High School Diploma -
Dothan High School