SHAWNTREL WILMORE

Here are strong, resume-ready bullet points that are concise, results-driven, and achievement-focused:

• Respond to high-volume calls, emails, and faxes from healthcare providers with professionalism, consistently delivering exceptional customer service.
• Serve as primary escalation point for high-impact provider and payer issues, driving root-cause resolution within SLA timeframes.
• Manage complex payer relationships (Humana, BCBSTN, MMO, GHP, Avera), ensuring seamless authorization workflows and operational excellence.
• Collaborate cross-functionally with clinical operations, product, and Provider Success teams to resolve inquiries and support implementation initiatives.
• Evaluate escalated cases to determine resolution paths and provide additional support.
• Analyze provider performance and utilization trends using Tableau dashboards, translating insights into actionable process improvements.
• Lead initiatives to reduce provider friction and backlog volumes, improving turnaround times through optimized escalation routing and communication workflows.
• Develop and deliver engaging training sessions tailored to diverse learning styles, enhancing team performance and job proficiency.
• Produce executive-level reports summarizing escalations, throughput trends, and resolution outcomes.
• Contribute to the development of escalation frameworks that reduced repeat incidents by 30%+, strengthening provider confidence and operational stability.

• Managed high volumes of calls via multi-lined phone system in virtual call-center environment, ensuring accurate responses by leveraging extensive knowledge of procedures.
• Scheduled COVID vaccine appointments for Center for Disease Control, creating effective calendaring systems to prioritize appointments based on urgency and clinic availability.
• Assisted customers with inquiries regarding products and services.
• Resolved customer complaints through effective communication and problem-solving.
• Processed orders and maintained accurate customer records in the database.

• Trained students on medical assisting policies, procedures, and best practices to adequately prepare and pass state exams with a 98% passing rate.
• Managed office supply and medical inventory levels; ordered supplies based on demand forecasts and budget constraints to ensure operational efficiency.
• Scheduled appointments for patients; created systems to effectively manage scheduling based on urgency and physician availability.
• Communicated effectively with insurance companies to obtain prior authorizations and verify coverages, eligibility, and copay amounts.
• Supported colleagues during high-volume shifts to uphold patient care standards and enhance patient experiences while maintaining accuracy and efficiency in a fast-paced environment.
• Provided executive-level administrative support, including data entry, documentation, and account management to streamline office operations.