Summary
Overview
Work History
Education
Skills
Timeline
Generic

Shelley Kibiloski

Eaton Rapids,MI

Summary

Professional with strong background in customer interactions and service solutions. Highly skilled in conflict resolution, communication, and problem-solving, ensuring customer satisfaction and loyalty. Effective team collaborator, adaptable to changing needs, and consistently focused on achieving results through efficient and empathetic service. Known for reliability and proactive approach to meeting customer and organizational goals.

Overview

37
37
years of professional experience

Work History

Case Management Coordinator

Physicians Health Plan
05.2020 - Current
  • Developed strong relationships with healthcare providers to ensure patient-centered care was consistently provided.
  • Identified potential barriers to successful outcomes, proactively developing action plans to mitigate risks or address challenges.
  • Referred clients to appropriate team members, community agencies and organizations to meet treatment needs.
  • Collaborated with providers and patients to obtain authorizations for needed services while minimizing out-of-pocket costs for patients.
  • Collaborated with employer groups and community partners to facilitate educational sessions outside of business hours.
  • Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
  • Worked well in a team setting, providing support and guidance.
  • Demonstrated respect, friendliness and willingness to help wherever needed.

Customer Service Specialist

Physicians Health Plan
08.2019 - 05.2020
  • Enhanced customer satisfaction by resolving issues promptly and professionally.
  • Responded to customer requests, offering excellent support and tailored recommendations to address needs.
  • Met customer call guidelines for service levels, handle time and productivity.
  • Actively participated in team meetings, continuously seeking opportunities to enhance skills and provide exceptional customer service.
  • Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
  • Collaborated with team members to develop best practices for consistent customer service delivery.
  • Participated in training programs to enhance product knowledge and customer service skills.

Credentialing Coordinator

Physicians Health Plan
11.2018 - 08.2019
  • Managed multiple priorities effectively, resulting in the on-time completion of credentialing tasks for numerous providers simultaneously.
  • Conducted primary source verifications such as background checks and board certifications.
  • Received and evaluated applications to look for missing and inaccurate information.
  • Safeguarded confidential provider information by adhering to strict data privacy regulations and company policies.
  • Updated and maintained accurate records in credentialing databases, ensuring timely renewals and verifications.
  • Skilled at working independently and collaboratively in a team environment.
  • Assisted with day-to-day operations, working efficiently and productively with all team members.
  • Passionate about learning and committed to continual improvement.

Senior Specialist

Physicians Health Plan
01.2011 - 01.2018
  • Established strong working relationships with clients through exceptional customer service and proactive communication efforts.
  • Followed all company policies and procedures to deliver quality work.
  • Developed training materials to enhance staff proficiency and productivity.
  • Enhanced customer satisfaction with timely and accurate issue resolution.
  • Self-motivated, with a strong sense of personal responsibility.
  • Paid attention to detail while completing assignments.
  • Assisted with day-to-day operations, working efficiently and productively with all team members.
  • Learned and adapted quickly to new technology and software applications.
  • Used critical thinking to break down problems, evaluate solutions and make decisions.
  • Developed and maintained courteous and effective working relationships.
  • · Provided coaching and mentoring to new hires, contributing to their successful integration into the team.

Deli Manager

Darrell's Market
01.2009 - 01.2011
  • Addressed customer concerns promptly and professionally, resolving issues to their satisfaction.
  • Improved efficiency in ordering processes, avoiding stockouts while minimizing overstock situations.
  • Monitored food inventory and supplies to prevent waste.
  • Optimized layout of deli counter for better product visibility and accessibility, enhancing customer shopping experience.
  • Enhanced customer satisfaction by maintaining high-quality standards for deli products and services.

Business owner/operator

Country Creek Rental Hall
01.1998 - 01.2009
  • Organized and catered events
  • Managed purchasing, sales, marketing and customer account operations efficiently.
  • Developed strategic business plan, guiding company towards sustainable growth and profitability.
  • Provided excellent customer service
  • Oversaw end-to-end business processes to maintain proficiency and profitability.
  • Cultivated strong relationships with suppliers/vendors to secure favorable pricing agreements for materials/services needed for daily operations.

Business owner/operator

Shelley’s Daycare
01.1995 - 01.1998
  • Responsible for the care of 12 children between age 0 to 12
  • Organized daily activity and behavior patterns of each child
  • Handled accounts payable and receivables
  • Tax preparation for CPA

Processor

Jackson National Life
01.1988 - 01.1995
  • Processor-Authorized and processed Annuity Policies/Manual calculations of withdrawals and federal tax withholding
  • Annuity Clerk-Effective written and verbal communication with policyholders, regional reps and agents
  • Authorized and processed contract changes
  • Mathematical calculations to satisfy IRS laws
  • Customer Service Rep-Worked extensively with regional office, agents and policyholders via phone
  • Service consisted of questions and issues pertaining to Life and Annuity insurance as well as Mutual Funds and Claims
  • Mentor-Advised and trained co-workers with phone, product and processing questions

Education

High School Diploma -

Eaton Rapids High School
Eaton Rapids
05-1986

Skills

  • Client advocacy
  • Patient communication
  • Case management
  • Time management abilities
  • Interpersonal skills
  • Discharge coordination
  • Follow-up care coordination
  • Teamwork and collaboration

Timeline

Case Management Coordinator

Physicians Health Plan
05.2020 - Current

Customer Service Specialist

Physicians Health Plan
08.2019 - 05.2020

Credentialing Coordinator

Physicians Health Plan
11.2018 - 08.2019

Senior Specialist

Physicians Health Plan
01.2011 - 01.2018

Deli Manager

Darrell's Market
01.2009 - 01.2011

Business owner/operator

Country Creek Rental Hall
01.1998 - 01.2009

Business owner/operator

Shelley’s Daycare
01.1995 - 01.1998

Processor

Jackson National Life
01.1988 - 01.1995

High School Diploma -

Eaton Rapids High School
Shelley Kibiloski