Summary
Overview
Work History
Education
Skills
Accomplishments
Languages
Work Availability
Timeline
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TAMIKA WILSON

TAMIKA WILSON

Hamilton,United States

Summary

Dynamic customer service professional with extensive experience at UnitedHealth Group, adept at navigating complex healthcare inquiries and resolving billing discrepancies. Proficient in CRM software and HIPAA compliance, I consistently deliver exceptional service while maintaining meticulous records. Recognized for achieving high customer satisfaction through effective communication and problem-solving skills.

Overview

21
21
years of professional experience

Work History

Customer Service Representative Healthcare Support-Remote

Healthcare Support
04.2024 - 12.2024
  • Demonstrated strong knowledge of healthcare products and services, effectively explaining coverage options and benefits to customers
  • Managed a high volume of incoming calls in a fast-paced environment, consistently meeting or exceeding call handling metrics
  • Assisted in the resolution of billing discrepancies by working closely with insurance companies and patients to ensure accurate payment processing
  • Provided support during open enrollment periods by guiding customers through the process of selecting appropriate healthcare plans
  • Served as a liaison between patients/families and healthcare providers/clinics/hospitals

Customer Service Representative

Staffing One Inc./Temp
Birmingham, United States
11.2023 - 05.2024
  • Assisted customers in navigating the company website, troubleshooting technical issues, and placing orders online
  • Maintained detailed records of all customer interactions in CRM system for future reference and analysis
  • Handled billing inquiries including payment processing, refunds, adjustments, and account updates accurately and efficiently
  • Proactively followed up with customers after issue resolution to ensure their satisfaction was maintained

Senior Chat Representative

Fetch Rewards
01.2022 - 03.2023
  • Research customer inquiries
  • Responded to customer using Zendesk
  • Corrected accounts
  • Applied rewards to accounts

Customer Service Representative

T-Mobile
Birmingham, AL
06.2017 - 06.2021
  • Managed a high volume of customer inquiries regarding billing and payment issues, providing prompt and accurate resolutions
  • Utilized billing software to process payments, refunds, and adjustments accurately and efficiently
  • Resolved complex billing discrepancies by investigating account history, collaborating with internal departments as needed
  • Consistently achieved a customer satisfaction rating of XX% by delivering exceptional service and addressing customer concerns in a timely manner

Customer Service Associate

Randstad Temp CIGNA
Birmingham, AL
09.2020 - 03.2021
  • Reviewed and processed medical claims for accuracy, completeness, and adherence to insurance policies and guidelines
  • Collaborated with healthcare providers to obtain additional documentation or clarification on claim details
  • Verified patient eligibility and coverage benefits prior to claim submission
  • Maintained a high level of productivity while meeting quality standards in processing a large volume of claims daily

Medical Appointment Scheduler

Evolent Health
04.2019 - 01.2020
  • Maintained strict confidentiality of protected health information to comply with HIPAA regulations
  • Verified and updated changes in patient, physician, or insurance to maintain proper billing
  • Scheduled appointments and assisted with referrals
  • Handled escalated calls professionally by listening carefully to the needs of each individual customer before offering appropriate solutions
  • Navigated multiple computer systems and applications and utilized search tools to find information
  • Calculated premiums and established payment methods
  • Prepared itemized statements, bills, and invoices, and recorded amounts due for items purchased

Phone Banker

Wells Fargo Bank
Birmingham, AL
03.2016 - 03.2017
  • Assisted customers with account transactions, including deposits, withdrawals, transfers, and bill payments
  • Provided exceptional customer service to banking clients, addressing inquiries and resolving issues in a timely and professional manner
  • Maintained thorough knowledge of banking products and services to effectively educate customers on available options
  • Closely monitored customer accounts for fraudulent activity or suspicious transactions, taking immediate action when necessary
  • Maintained accurate records of all interactions with customers using the bank's CRM system
  • Investigated discrepancies in account balances or transaction history to identify errors or potential fraud cases
  • Conducted regular follow-ups with customers to ensure their satisfaction after resolving issues or completing transactions

Medical Claims Representative

UnitedHealth Group
Frederick, MD
10.2014 - 05.2015
  • Demonstrated strong knowledge of healthcare products and services, effectively explaining coverage options and benefits to customers
  • Managed a high volume of incoming calls in a fast-paced environment, consistently meeting or exceeding call handling metrics
  • Provided exceptional customer service to patients and their families, addressing inquiries, resolving issues, and ensuring a positive experience
  • Maintained detailed records of customer interactions using CRM software, ensuring accurate documentation for future reference

Airport Security Screener

Tsa
12.2003 - 09.2014
  • Explained partial and full denials for items not covered under policies
  • Conducted timely reviews of claims to ensure accuracy and completeness of documentation
  • Utilized appropriate job aids, knowledge, and tools to process initial reception of claims
  • Reviewed insurance policy to determine coverage
  • Transcribed data to worksheets and entered data into computer for use in preparing documents and adjusting accounts
  • Calculated premiums, refunds, commissions, adjustments, and new reserve requirements, using insurance rate standards
  • Involved persons to obtain missing information

Education

GED -

Faulkner University
Montgomery, AL

Skills

  • CRM
  • CRM Software
  • HelpDesk
  • HIPAA
  • Microsoft Office
  • Cm1500
  • Eob
  • Microsoft Outlook
  • Gmail
  • Medicaid
  • Medicare
  • Zenkdesk

Accomplishments

  • High Customer Satisfaction, Achieved customer satisfaction rating of 95% by resolving issues promptly and effectively.
  • Billing Discrepancy Reduction, Reduced billing discrepancies by 30% via collaborative efforts with insurance partners.
  • Volume Management Excellence, Handled 50+ customer interactions daily while maintaining service quality and standards.

Languages

English, Native

Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline

Customer Service Representative Healthcare Support-Remote

Healthcare Support
04.2024 - 12.2024

Customer Service Representative

Staffing One Inc./Temp
11.2023 - 05.2024

Senior Chat Representative

Fetch Rewards
01.2022 - 03.2023

Customer Service Associate

Randstad Temp CIGNA
09.2020 - 03.2021

Medical Appointment Scheduler

Evolent Health
04.2019 - 01.2020

Customer Service Representative

T-Mobile
06.2017 - 06.2021

Phone Banker

Wells Fargo Bank
03.2016 - 03.2017

Medical Claims Representative

UnitedHealth Group
10.2014 - 05.2015

Airport Security Screener

Tsa
12.2003 - 09.2014

GED -

Faulkner University

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