ShaQuanna Wilson
Columbia,SC
Summary
Dedicated and hard-working customer service representative with years of work experience aiming to satisfy the customer needs. Proven knowledge of conflict resolution, customer needs assessment and health care management skills, I can be relied upon to make sure all customers are satisfied with the health care experience.
Overview
8
8
years of professional experience
Work History
Claims Customer Service Advocate III
Palmetto Gba
01.2021 - Current
- Performed non-medical reviews and processes redetermination letters according to Medicare regulations
- Answer provider calls and assist with eligibility and claim status; claims denials and all other inquiries.
- Provide information pertaining to Medicare coverage and processing standards
Customer Service Advocate II
Blue Cross & Blue Shield Of SC
09.2018 - 01.2021
- First point of contact for customer inquiries
- Took ownership of customers issues to follow problems through to resolution
- Processed adjustments and performed other researched needed to solve customers inquiries
Customer Care Specialist
Conduent Business Services
11.2017 - 08.2018
- Verified accuracy of customer account information and updated when necessary.
- Provided accurate information according to Medicaid guidelines and eligibility
- Communicated appropriated options for resolutions in a timely manner
Customer Service Advocate
Blue Cross & Blue Shield Of SC/PAI
07.2016 - 11.2017
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Assisted beneficiaries and providers with information pertaining to the limited benefits
- Quoted benefit packages
Customer Service Representative
Teleperformance USA/ Wellcare
01.2016 - 07.2016
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Handled customer inquiries and suggestions courteously and professionally.
- Assisted with order placement allowed within managed care plan
Education
Bachelor of Science - Accounting And Finance
Strayer University
Washington, DC05.2024
EKG Technician
Professional Medical Training
Conway, SC05.2013
Skills
- Strong verbal communication
- Analytical or critical thinking
- Proficient with microsoft programs
- Active listening
- Customer relations
- Health insurance industry knowledge
- Ability to handle confidential or sensitive information
Timeline
Claims Customer Service Advocate III
Palmetto Gba
01.2021 - Current
Customer Service Advocate II
Blue Cross & Blue Shield Of SC
09.2018 - 01.2021
Customer Care Specialist
Conduent Business Services
11.2017 - 08.2018
Customer Service Advocate
Blue Cross & Blue Shield Of SC/PAI
07.2016 - 11.2017
Customer Service Representative
Teleperformance USA/ Wellcare
01.2016 - 07.2016
Bachelor of Science - Accounting And Finance
Strayer University
EKG Technician
Professional Medical Training
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