Siara Williams
McDonough,GA
Summary
Dynamic and results-driven professional with expertise in insurance claims, dispute resolution, and patient advocacy across the healthcare and financial services industries. Adept at analyzing complex data, managing client relationships, and delivering tailored solutions that drive satisfaction and compliance. Recognized for strong communication, adaptability, and a consistent record of exceeding performance standards.
Overview
6
6
years of professional experience
Work History
Patient Care Advocate
Cigna Evernorth
09.2024 - Current
- Answered inbound calls from members, providers, and pharmacies regarding Pharmacy Benefit Management inquiries.
- Maintained quality and productivity standards across all transactions.
- Documented all contacts accurately to ensure compliance with HIPAA regulations.
- Educated patients on pharmacy benefits, including drug coverage and pricing structures.
- Advocated for members by contacting physician offices to obtain prescriptions for fulfillment.
- Actively sought feedback from patients about their experiences within the healthcare system in order to improve service delivery models.
- Trained new staff on best practices for patient advocacy and service excellence at Cigna Evernorth.
Auto Insurance Claims Administrator
State Farm Insurance
09.2022 - 06.2024
- Spearheaded comprehensive management of auto insurance claims, ensuring adherence to State Farm service standards.
- Scrutinized claim documentation, including accident reports and repair estimates, for validity and accuracy.
- Communicated effectively with policyholders, agents, and stakeholders to gather information and clarify policy details.
- Collaborated with adjusters and appraisers to negotiate and resolve complex claims efficiently.
- Maintained meticulous records of claims information and correspondence, exceeding regulatory compliance requirements.
- Identified potential issues in claims handling and suggested improvement strategies.
Insurance Dispute Resolution Analyst
Concentrix
11.2021 - 09.2022
- Conducted comprehensive analysis to resolve insurance claims disputes, ensuring equitable outcomes.
- Utilized advanced analytical tools to evaluate claim documentation and identify areas of contention.
- Collaborated with claims adjusters, legal teams, and underwriters to assess liability and negotiate settlements.
- Served as liaison between policyholders, external parties, and regulatory bodies to facilitate communication.
- Maintained accurate records of dispute resolution activities to ensure compliance with regulations.
- Provided feedback on system improvements based on observed customer interactions.
Customer Experience Specialist
Big Lots Stores
09.2020 - 03.2021
- Delivered exceptional customer service, fostering lasting loyalty through personalized interactions.
- Utilized advanced point-of-sale systems to ensure accurate transaction processing.
- Collaborated with team members to maintain an organized and visually appealing store environment.
- Implemented strategic product displays and meticulous restocking to enhance customer experience.
- Exceeded sales targets by identifying upselling and cross-selling opportunities.
- Resolved complex customer issues with professionalism, receiving consistent praise and recognition.
- Achieved outstanding performance evaluations from supervisors for exceeding expectations.
Guest Experience Coordinator
Georgia World Congress Center
04.2019 - 02.2021
- Delivered exceptional guest services at Georgia World Congress Center, ensuring memorable experiences.
- Demonstrated comprehensive knowledge of facility layout, amenities, and event schedules for effective guest assistance.
- Managed guest check-in and registration processes, utilizing computer systems for efficient entry.
- Collaborated with event organizers to coordinate logistics and address guest concerns promptly.
- Identified opportunities to enhance guest experience through personalized assistance and anticipatory service.
Education
Bachelor of Science - Social & Behavioral Health
University of West Georgia
Carrollton, GA07.2021
High School Diploma -
Riverdale High School
Riverdale, GA05-2017
Skills
- Effective communication
- Leadership
- Research and analysis
- Risk assessment and management
- Customer focus and engagement
- Relationship management
- Cross-functional collaboration
- Attention to detail
- Fraud detection and prevention
- Market analysis and insights
- Analytical thinking
- Upselling strategies
- HIPAA compliance
- Technical troubleshooting
References
References available upon request.
Timeline
Patient Care Advocate
Cigna Evernorth
09.2024 - Current
Auto Insurance Claims Administrator
State Farm Insurance
09.2022 - 06.2024
Insurance Dispute Resolution Analyst
Concentrix
11.2021 - 09.2022
Customer Experience Specialist
Big Lots Stores
09.2020 - 03.2021
Guest Experience Coordinator
Georgia World Congress Center
04.2019 - 02.2021
Bachelor of Science - Social & Behavioral Health
University of West Georgia
High School Diploma -
Riverdale High School
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