Shilexus Williams-Mcdowell
Raleigh,NC
Summary
Skilled Member Support Representative with a strong focus on patient management and claims processing. Known for exceptional attention to detail and dedication to providing outstanding customer service in a fast-paced healthcare environment.
Overview
6
6
years of professional experience
Work History
Member Care Representative
Florida Blue
08.2025 - 08.2025
- Reviewed enrollment and claims history to confirm billing accuracy and member responsibilities.
- Accurately entered patient payments into billing system, ensuring proper financial records.
- Provided exceptional customer service by addressing inquiries and resolving complaints.
- Adhered to HIPAA regulations to maintain confidentiality of client information.
Member Support Representative
Teleperformance USA
02.2021 - 08.2022
- Assisted members with healthcare claims and benefit inquiries via phone, ensuring timely, accurate information delivery.
- Verified member eligibility and benefits to confirm appropriate coverage and services.
- Maintained strict HIPAA compliance while managing sensitive member information and documenting interactions.
- Documented all interactions accurately in CRM and claims management systems for effective auditing and reporting.
Technical Support Representative
Kelly Connect
01.2020 - 02.2021
- Served as primary contact for incoming technical service calls and emails.
- Efficiently handled password resets, failed authentications, and portal registrations.
- Troubleshot hardware, network, software, and service-related requests to provide remote client support.
- Completed documentation per department policies to ensure compliance.
Education
Associate of Applied Science - Medical Office Administration
Wake Technical Community College
Raleigh, NC12-2026
Skills
- Medical terminology
- Patient management
- Electronic health records
- HIPAA compliance
- Customer service
- Claims processing
Timeline
Member Care Representative
Florida Blue
08.2025 - 08.2025
Member Support Representative
Teleperformance USA
02.2021 - 08.2022
Technical Support Representative
Kelly Connect
01.2020 - 02.2021
Associate of Applied Science - Medical Office Administration
Wake Technical Community College
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