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Sharrell
Contacto
Competencias
Demonstrated experience with Microsoft Word.
Demonstrated experience with Microsoft Excel.
Demonstrated experience with Outlook.
Demonstrated experience with Teams.
Demonstrated experience with Email & Calendar Platforms.
Educacion
Resumen
Professional profile
Experiencia
Customer Service Representative II
Handled 60+ customer interactions per day involving account questions, benefits, eligibility, healthcare services, and general member support.. Researched customer concerns across multiple systems, identified the source of issues, and provided accurate next steps while maintaining a professional tone.. De-escalated frustrated customers through active listening, clear explanations, and solution-focused communication.. Documented interactions accurately and consistently while protecting confidential member information and following established procedures.. Balanced call quality, productivity, documentation, and schedule expectations in a fast-paced remote customer service environment.
Claims & Benefit Operations Specialist I
Reviewed claims, referrals, eligibility information, and supporting documentation for accuracy and appropriate processing.. Applied benefit guidelines and medical-necessity criteria to identify discrepancies, missing information, and potential processing issues.. Investigated claim and account discrepancies, researched available information, and routed complex issues for appropriate resolution.. Maintained detailed documentation and handled protected healthcare information in accordance with company procedures and privacy requirements.. Managed competing priorities while meeting processing timelines, maintaining accuracy, and communicating clearly with internal teams.
Caregiver / Direct Support Professional
Provided dependable day-to-day support while maintaining patience, professionalism, and respect for individual needs.. Communicated observations and important updates clearly to appropriate care-team contacts and maintained accurate information.. Supported individuals with developmental and intellectual disabilities while responding calmly to challenging situations.. Followed care instructions, safety expectations, and documentation requirements while maintaining confidentiality.