Shariqua Wiley
Columbia,SC
Summary
5+ years’ of excellent customer service experience, with 2+years in a healthcare call center setting, including WFH setting experience working with Medicare, Medicaid, BCBS, Sutter Health, and Epic; Strong working knowledge of health insurance: benefits/coverage, deductibles, insurance verification and processing prior authorization; Accustomed to high call volume and metric driven environments; coachable and can easily adapt to company software; Organized and dependable candidate successful at managing multiple priorities with a positive attitude.
Overview
11
11
years of professional experience
Work History
Home Health Care Tech
Personal Care Plus
06.2023 - Current
- Implement care in supporting elderly patients while providing compassionate and attentive care daily
- Provide mobility assistance to help my patients maintain their independence
- Assist with daily living needs including: bathing, feeding, doing hair, providing meds, etc
- Assist patients on transports to a variety of establishments for personal and medical use
- Perform light housekeeping duties such as: washing dishes, doing laundry, vacuuming, and feeding pets
- Massage and apply topical treatments to comfort patient as needed
- Document daily observations and progress in patient records, maintaining accurate information for healthcare team members
Patient Medical Scheduler
Sutter Health- (Robert Half Staffing)
11.2021 - 04.2023
- Responded to telephone calls promptly, professionally and courteously to establish, cancel, reschedule or confirm appointments for many physicians within the Sutter Health medical facilities
- Maintained confidentiality of patient information to comply with HIPAA regulations and protect patient privacy during all aspects of appointment scheduling process
- Utilized appropriate scheduling codes and slots in scheduling office/hospital visits for medical procedures
- Increased patient retention, providing exceptional customer service during appointment scheduling interactions.
- Facilitated smooth communication between patients and healthcare providers, addressing inquiries or concerns related to emergency situations
- Maintained accurate patient records/notation for proper tracking of patient history and treatment
- Reduced patient wait times by effectively managing schedules for multiple healthcare providers.
Provider Service Claims Rep
Blue Cross Blue Shield- (Kelly Service Staffing)
06.2020 - 10.2021
- Responded to routine correspondence and high volume telephone inquiries pertaining to claims or appeals
- Identified incorrectly processed claims and completed adjustments and related reprocessing actions
- Handled all confidential and sensitive information with discretion
- Interviewed policyholders to verify information and obtain additional details
- Verified insurance coverage, and communicated specific benefit information to providers
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents
- Maintained strong knowledge of basic medical terminology to better understand services and procedures
- Processed prior authorizations, and informed on whether prior-auth was needed or not for certain procedures
- Prepared and presented detailed reports to management on claims issues to aid in decision making.
Patient Care Asst
Visiting Angels
06.2017 - 05.2020
- Improved client's daily living experience by providing personal care, meal preparation, and light housekeeping tasks
- Assisted with bathing, showering, and grooming as needed
- Took patient to scheduled appointments, and provided patient with prescribed medications at designated times
- Developed rapport to create safe and trusting environment for care
- Provided emotional support for patients and families, fostering a positive home environment
- Safeguarded patient privacy by maintaining strict confidentiality of personal information and adhering to HIPAA guidelines
- Addressed emergency situations promptly and effectively while adhering to established protocols for crisis intervention and escalation when necessary
Sales Support Desk Lead
Time Warner Cable
08.2015 - 03.2017
- Supported all vendors, sales and retention and internal agents by assisting to facilitate and answer their questions via the Support (Help) Desk queue
- Assisted and supported agents’ incoming inquiries and issues related to the sales process and how to enter in sales orders correctly
- Communicated while notating accounts at the same time on every call
- Made judgement calls within scope, and communicated with customers only on escalated matters
- Gave authorization to cancel work orders for agents if within cancellation guidelines
- Assisted agents with overrides for credit check if customer meets qualifications for a bypass
- Contacted risk management to verify payments and have restricted accounts unblocked if possible
- Multi-tasked using 3 monitors at 1 time with the use of TWC systems daily (CSG, ICOMS).
Medicaid Customer Service Representative
United Way Association
05.2013 - 07.2015
- Answered high volume of calls consistently and returned calls to customers to provide information needed
- Assisted members with the process of applying for Medicaid health coverage, and informed applicants of their status for already completed applications
- Verified documents received by fax, mail, or email
- Used proficient data entry skills to accurately document and input statements/ notate the account
- Provided members with further information needed to process their case
- Informed recipients of information regarding the different Medicaid plans, types of services covered by Medicaid, and copays
- Assisted clients in understanding their Medicaid benefits, explaining complex regulations and policies with clarity
- Maintained up-to-date knowledge of changes in Medicaid regulations, sharing relevant updates with team members as well and members
Bank Teller
Wells Fargo
10.2012 - 04.2013
- Handled large amounts of cash daily
- Balanced currency, coin, checks and cash drawers daily and accurately at the beginning and end of each shift, minimizing discrepancies in financial records
- Paid strict attention to detail; Examined checks for correct endorsements, dates of checks and observant of counterfeit money
- Processed monetary transactions including (deposits, withdrawals, checks, payments, and cash advances)
- Received mortgage, loan or public utility bill payments, verifying payment dates and amounts due
- Offered bank services that best met the customers’ financial needs; meeting individual as well as team customer service and sales goals
- Improved customer satisfaction by efficiently processing transactions and addressing account inquiries
Education
Bachelor of Science - Business Management
Grand Canyon University
Phoenix, AZ01.2026
Associate of Science - Medical Assistant
Virginia College
Columbia, SC01.2013
High School Diploma -
Lugoff-Elgin High School
Lugoff, SC01.2009
Skills
- Customer Service
- Data Entry
- Clerical Support
- Appointment Scheduling
- Complaint/ Conflict Resolution
- De-Escalation Techniques
- Computer and Office Equipment Proficiency
- Payment Processing
- Microsoft Office Suite, Outlook, PP and Excel
- Medical Terminology Knowledge
- Live Chat Support and Technical Support
- Product Promotion and Service Upselling
- Call Center Experience
Timeline
Home Health Care Tech
Personal Care Plus
06.2023 - Current
Patient Medical Scheduler
Sutter Health- (Robert Half Staffing)
11.2021 - 04.2023
Provider Service Claims Rep
Blue Cross Blue Shield- (Kelly Service Staffing)
06.2020 - 10.2021
Patient Care Asst
Visiting Angels
06.2017 - 05.2020
Sales Support Desk Lead
Time Warner Cable
08.2015 - 03.2017
Medicaid Customer Service Representative
United Way Association
05.2013 - 07.2015
Bank Teller
Wells Fargo
10.2012 - 04.2013
Bachelor of Science - Business Management
Grand Canyon University
Associate of Science - Medical Assistant
Virginia College
High School Diploma -
Lugoff-Elgin High School
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