Summary
Overview
Work History
Education
Skills
Additional Information
Timeline
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Shantiqua Dowe

Leland,NC

Summary

Knowledgeable and dedicated customer service professional with extensive experience in medical/hospital and insurance industries. Solid team player with outgoing, positive demeanor and proven skills in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality, speed and process optimization. Articulate, energetic and results-oriented with exemplary passion for developing relationships, cultivating partnerships and growing businesses.

Overview

11
11
years of professional experience

Work History

Retail Claims Adjuster

American Express
02.2023 - Current
  • Role is within the Claim and Servicing Operations department of AAC
  • Deliver extraordinary customer service to cardmembers on inbound calls, with the possibility of taking over a claim regardless of if it has been worked by another colleague.
  • Responsible for handling claims for Retail products in the AMEX Assurance Insurance products portfolio.
  • Evaluated insurance policies and analyzed damages to determine coverage.
  • Prepared summaries of damage, payments, and policy coverage.
  • Established relationships with clients and insurance companies to foster timely claims resolution.
  • Answered customer questions regarding deductibles.
  • Examined claims forms and other records to determine insurance coverage.
  • Verified insurance claims and determined a fair amount for settlement.
  • Researched and analyzed policy contracts to verify proper payment of claims.
  • Documented all investigation activity and presented reports to management.
  • Reviewed police reports, medical treatment records, and physical property damage to determine the extent of liability.
  • Substantiated legitimate claims and denied unjustified claims.
  • Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
  • Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
  • Conducted day-to-day administrative tasks to maintain information files and process paperwork.
  • Responsibilities also included investigations, maintaining compliance for a variety of states including Puerto Rico and the U.S Virgin Islands, settling claims for these products, and having direct interaction with customers.

Customer Care Professional

American Express
04.2022 - 02.2023
  • Delivered extraordinary service on inbound calls in a fast-paced, structured customer care environment by following our Customer First philosophy.
  • Assisted over 50 call-in customers per day with questions and orders.
  • Navigated multiple computer systems and applications to find information.
  • Addressed customer complaints and mitigated dissatisfaction by employing timely and on-point solutions.
  • Met customer call guidelines for service levels, handle time, and productivity.
  • Maintained up-to-date knowledge of product and service changes.
  • Exhibited high energy and professionalism when dealing with clients and staff.
  • Helped a large volume of customers every day with a positive attitude and focus on customer satisfaction.
  • Leveraged sales expertise to promote products and capitalize on upsell opportunities.
  • Responded to customer needs through competent customer service and prompt problem-solving.
  • Consult with card members to understand their needs and tailor unique solutions for each customer, reinforcing benefits of card membership, and providing relevant product offers that deepen customer engagement and result in measurable value for cardmembers.

Fraud Agent

Spherion Staffing Agency
06.2021 - 01.2022
  • Project for Pennsylvania Labor and Industry called the PA PUA (Pennsylvania Pandemic Unemployment Assistance) and UC (Unemployment Compensation) Fraud Hotline Project.
  • Fully trained on incoming and outbound processes for fraud calls.
  • Performed risk assessments to determine thelevel of fraud risk and prioritize investigations.
  • Produced detailed reports of fraud investigations and presented findings to senior management.
  • Coached and trained staff on fraud prevention techniques to increase awareness and reduce risk.
  • Evaluated customer data to identify and prevent fraudulent activities.
  • Analyzed large amounts of data to find patterns of fraud and anomalies.
  • Given access to a government e-mail address with the Commonwealth of Pennsylvania and the portal that is used to assist claimants with PUA/UC Unemployment claims
  • Initially, my job was to make sure that the correct fraud form had been filled out by the victim (individual or employer) or the caller and to flag the account for investigation, if needed, to ensure the seizure of any fraudulent claims.
  • I was identified as one of their strongest agents from the fraud teams and was moved to the triage fraud team. On this team, I was specifically trained on triaging voicemails. I was given special access to be able to view a voicemail resource account to listen to fraud voicemails.
  • With this access, I worked to document voicemails by categorizing them by importance and call type, which included pertinent details for fraud cases so that call representatives could return calls to the individuals.
  • Fraud calls consisted of confidential information that could be brought into a court of law.
  • After successfully triaging 50,000+ backlog of voicemails for the Commonwealth of Pennsylvania, I returned to outbound calls with my triage team and was moved shortly after to a leadership position to help guide the rest of the call representatives, who were not as confident in their position.

Tier 1 Technical Support Advisor

Kelly Services
03.2021 - 05.2021
  • Provided excellent customer service to 50+ Apple consumers daily.
  • Resolved technology challenges through a series of troubleshooting activities and knowledge-based research in a virtual call center environment.
  • Completed the Apple at Home program by passing all exams, mid-terms, and customer-facing time (CFT) training.
  • Researched and identified solutions to technical problems.
  • Helped streamline repair processes and update procedures to support action consistency.
  • Broke down and evaluated user problems, using test scripts, personal expertise, and probing questions.
  • Responded to customer inquiries and provided technical assistance over the phone and in person.

Environmental Services Technician

Novant Health Brunswick Medical Center
11.2020 - 03.2021
  • Maintained overall cleanliness and sanitation of the healthcare facility.
  • Worked with team members from multiple departments to maintain strict cleanliness standards.
  • Handled spills in work and common areas and used proper methods to clean and sanitize each material.
  • Performed a range of cleaning tasks, from mopping to room sanitizing and waste disposal.
  • Enthusiastically, performed all cleaning duties in designated areas assigned.
  • Thoroughly deep-cleaned rooms for patients who were discharged from the hospital.
  • Assisted in cleaning outside areas, Emergency Room cleans and was fully trained on how to clean all Operating Rooms, to ensure top-notch cleanliness for upcoming surgeries.
  • Maintained patient and hospital confidentiality.
  • Maintained spotless restrooms and break rooms with a detail-oriented approach and consistent attention.
  • Followed specific cleaning schedules based on patient needs.
  • Monitored spaces for environmental safety hazards.
  • Provided customer service to hospital patients upon entry to their rooms for routine cleaning.
  • Used AIDET (Acknowledge, Introduce, Duration, Explain, and Thank You) to ensure patients were being provided the best customer service.
  • Adhered to all COVID-19 protocols when cleaning COVID rooms.
  • Gained trust with and showed great responsibility skills to my operations manager and was given access to manage the environmental services team when she was not present.
  • Access to the management system gave me the control to view the Bed Board on the EPIC interface to see the status and needs of the hospital, assess accordingly, and send out assignments to other co-workers, as needed.
  • Completed regular room audits on clean discharge rooms for quality assurance.

Custodian

Cape Fear Community College
08.2019 - 11.2020
  • Maintained overall cleanliness and sanitation of the college building assigned.
  • Helped to keep the educational facilities clean and safe for the professors, teachers, and students.
  • Kept building spaces and premises clean inside and outside.
  • Managed the entire building I was assigned to and assigned work to my evening direct support staff.
  • Remained teachable and was able to take direction from supervisor and operations managers.
  • Emptied trash cans and recycling bins to keep the building clean and free of germs.
  • Replaced and refilled paper towels and toilet paper dispensers for users' convenience.
  • Maintained clean and comfortable environments in commercial buildings by vacuuming, cleaning windows, and dusting.
  • Handled spills, accidents, and other cleaning emergencies to maintain cleanliness standards throughout assigned shifts.
  • Followed safety protocols and safe use of protective gear to prevent injury to self and others.
  • Inspected facility and grounds and picked up trash or other debris impacting appearance or movement flows between spaces.
  • Moved furniture for cleaning and set up for special events.
  • Checked in and stocked inventory throughout the facility.
  • Mixed, used, and properly stored hazardous chemical cleaners to reduce the risk of injury or illness.
  • Cleaned equipment and machinery to maintain optimum working conditions.
  • Maintained cleanliness of restrooms by washing down and properly sanitizing walls, floors, and toilets.
  • Kept public pathways clear of safety hazards and spills with regular checks and attention.

Environmental Services Technician

New Hanover Regional Medical Center
03.2017 - 08.2019
  • Maintained overall cleanliness and sanitation of the healthcare facility.
  • Performing a range of cleaning tasks, from mopping to room sanitizing and waste disposal.
  • Enthusiastically, performed all cleaning duties in designated areas assigned.
  • Cleaned 22 patient rooms a day, plus public outside areas of the designated hospital floor.
  • Used AIDET (Acknowledge, Introduce, Duration, Explain, and Thank You) to ensure that patients were provided the best customer service.
  • Kept public pathways clear of safety hazards and spills with regular checks and attention.
  • Full deep cleaning was required in rooms that patients were discharged from.
  • Worked with team members from multiple departments to maintain strict cleanliness standards.
  • Handled spills in work and common areas and used proper methods to clean and sanitize each material.
  • Maintained patient and hospital confidentiality.
  • Maintained spotless restrooms and break rooms with a detail-oriented approach and consistent attention.
  • Monitored spaces for environmental safety hazards.
  • Prepared cleaning solutions and equipment in accordance with health and safety standards.
  • Mixed, used, and properly stored hazardous chemical cleaners to reduce the risk of injury or illness.
  • Responded to emergency sanitation needs in a prompt and professional manner, alerting hazmat professionals in alignment with OSHA requirements.

Mental Health Technician

Strategic Behavioral Center
02.2015 - 02.2017
  • Observed and influenced patient behaviors and interactions towards prescribed treatment goals.
  • Objectively documented clinical observations in the electronic medical records, shift reports, and treatment planning meetings.
  • Assisted in managing the milieu (i.e acuity, family involvement, and activities of daily living.)
  • Collaborated with physicians, psychiatric nurses, and therapists in assessing, guiding, and encouraging patients towards measurable therapeutic outcomes.
  • Conducted informal psycho-educational, recreational, and interpersonal skills development groups.
  • Performed scheduled patient safety checks and documented results to establish patients' well-being.
  • Applied de-escalation and limit-setting techniques to promote patient cooperation.
  • Assisted with patient restraint and seclusion scenarios to create safe environment for patient and medical personnel.
  • Developed and maintained positive relationships with clients to create safe and supportive environment.
  • Observed patient behaviors and mental status and notified RN of unusual or potentially dangerous occurrences.
  • Helped patients with meals, activities of daily living (ADLs) and facility transfers to promote security and patient well-being.
  • Escorted patients from unit to meals, activities, and visitation areas to maintain standard of safety and security.
  • Identified behaviors that necessitated intervention and obtained assistance from qualified personnel to complete intervention.
  • Facilitated group therapy sessions to help clients develop coping strategies and social skills.
  • Participated in multidisciplinary team meetings to discuss progress and treatment plans of clients.
  • Supported patient confidentiality in accordance with HIPAA regulations.
  • Treated clients and families with respect and dignity.
  • A highlight of my work was that I was hand-picked by supervisors to be trained on client chart auditing and became a chart auditor from 2016-2017 during my time at this company.

Machine Operator

YS Companies
01.2013 - 02.2015
  • Operated machining equipment safely with team of operators.
  • Operated multiple machines simultaneously to meet production requirements.
  • Followed detailed instructions to operate machines with accuracy and produce quality products.
  • Complied with company and OSHA safety rules and regulations.
  • Performed routine maintenance on machines.
  • Adhered to company policies and procedures.
  • Performed lockout tagout on machine before performing preventive maintenance on machine.

Education

Business Administration

Cape Fear Community College
Wilmington
05.2025

No Degree -

Livingstone College
Salisbury

High School Diploma -

North Brunswick High School
Leland
06.2011

Skills

  • Microsoft Office MS Excel, PowerPoint, Word, SharePoint, etc
  • Avaya One-X, Microsoft Teams, Genesys
  • MacOS Windows Operating Systems
  • Technical Support
  • Environmental Services
  • Strong Interpersonal and Communication Skills
  • Professionalism
  • Training and Development
  • Problem Solving
  • Teamwork Abilities
  • Ethical Conduct
  • Medical Terminology
  • Decision-Making
  • Auditing
  • Quality Assurance
  • Hospital Experience
  • EPIC
  • Claims Processing
  • [All States] Claims Adjuster License - NC Based
  • Documentation review
  • Transcribing text
  • Casualty and Property Loss
  • Data Management
  • Report Generation
  • Critical Thinking
  • Effective Communication
  • Product Knowledge
  • Adaptability
  • Escalation Management
  • Security Awareness
  • Customer Verification
  • Risk Assessment

Additional Information

  • Willing to relocate anywhere with relocation assistance.
  • Authorized to work in the US for any employer.

Timeline

Retail Claims Adjuster

American Express
02.2023 - Current

Customer Care Professional

American Express
04.2022 - 02.2023

Fraud Agent

Spherion Staffing Agency
06.2021 - 01.2022

Tier 1 Technical Support Advisor

Kelly Services
03.2021 - 05.2021

Environmental Services Technician

Novant Health Brunswick Medical Center
11.2020 - 03.2021

Custodian

Cape Fear Community College
08.2019 - 11.2020

Environmental Services Technician

New Hanover Regional Medical Center
03.2017 - 08.2019

Mental Health Technician

Strategic Behavioral Center
02.2015 - 02.2017

Machine Operator

YS Companies
01.2013 - 02.2015

Business Administration

Cape Fear Community College

No Degree -

Livingstone College

High School Diploma -

North Brunswick High School

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Shantiqua Dowe