Summary
Overview
Work History
Education
Skills
LNGG
Timeline
Generic

Kelsey Walker

Newport News

Summary

Reliable and results-driven professional with over three years of experience delivering high-quality customer service and administrative support in fast-paced environments. Skilled in managing high call volumes, resolving complex issues, and maintaining accurate records with attention to detail. Known for strong communication, problem-solving, and multitasking abilities, along with a commitment to professionalism and client satisfaction. Eager to contribute a positive attitude and proven work ethic to a team-oriented organization.

Overview

4
4
years of professional experience

Work History

Customer Service Representative

Sentara Health Plans
03.2024 - Current
  • Deliver comprehensive customer service from start to finish, ensuring operational excellence, and contributing to the security, comfort, and resolution of employee and client concerns.
  • Perform self-assessments, observations, root cause analyses, and related practices to uphold and enhance reliability, operational goals, and client safety.
  • Efficiently allocate resources and provided necessary support to enable teams to achieve operational goals.
  • Successfully managed and completed multiple tasks simultaneously, adhering to deadlines through effective time management and organizational skills.
  • Demonstrates proficiency in dispute resolution and validating concerns of clients and dental providers to foster satisfaction and establish common ground.
  • Exhibits sharp critical thinking and decision-making abilities under time and pressure constraints.
  • Handles incoming calls to deliver customer service to plan members, providers, and insurance groups, addressing benefit inquiries, resolving issues promptly, and educating members.
  • Researches and processed claims and pre-authorizations
  • Verifies benefits and eligibility for members
  • Maintains a positive, empathetic, and professional demeanor during interactions with members and colleagues.
  • Manages incoming and outgoing calls, delivering customer service to plan members, providers, and employer groups by addressing benefit inquiries, resolving issues promptly, and educating members.
  • Documents inquiry outcomes comprehensively for accurate tracking and analysis.
  • Assists individuals in understanding their benefits, responsibilities, services, and solutions to address their financial concerns.
  • Researches and processed claims, appeals, grievances, medical authorizations, and pharmacy authorizations.
  • Informs clients of premium discrepancies through payment adjustment notifications.

Customer Service Representative

DentaQuest Medicaid
07.2022 - 01.2024
  • Provides start to end great customer service & empathy while fostering operational excellence, which results in employee and client security, comfort, and problem resolution
  • Conducts self audits, observations, root cause analyses, and other relevant practices to maintain and increase dependability, operation objectives, and client security
  • Effectively distributes resources and offers necessary assistance to enable teams to carry out operational objectives
  • Manages and completes a number of tasks simultaneously, on schedule using astute time management and organizational skills
  • Demonstrates expertise in resolving disputes and validating concerns of clients and dental providers to create satisfaction and neutral ground
  • Brisk critical thinking and decision making skills in a time and pressure constrained setting
  • Responds to incoming calls to provide customer service to plan members, providers and insurance groups by answering benefit questions, promptly resolving issues and educating members
  • Research and file claims and pre authorizations
  • Verifying members’ dental benefits and eligibility
  • Maintain a positive, empathetic, and professional tone during member and colleague interactions

Customer Service Representative

CareSource
06.2021 - 07.2022
  • Responded to incoming calls and initiated outgoing calls, provided customer service to plan members, providers and employer groups by answering benefit questions, promptly resolving issues and educating members
  • Thoroughly documented inquiry outcomes for accurate tracking and analysis
  • Assisted individuals in understanding their benefits, member responsibilities, services and best solutions to meet their personal financial concerns
  • Researched and filed claims, appeals, grievances, medical authorizations, as well pharmacy authorizations
  • Notified clients of premium discrepancies through payment adjustment notices

Education

High School -

Warwick High School
NEWPORT NEWS, VA

MEDICAL SCIENCES

ECPI University
Virginia Beach, VA

Skills

  • Data logging and integration expertise
  • Clinical experience in healthcare settings as an LPN
  • Medical industry experience
  • Experience in government and commercial sectors
  • Detail-oriented data management
  • Client support
  • Analytical reasoning
  • Telecommunications proficiency
  • Effective conflict resolution
  • Effective complaint management
  • Polished phone etiquette
  • Customer service operations
  • Process documentation
  • Office administration support

LNGG

English, Jamaican Patois

Timeline

Customer Service Representative

Sentara Health Plans
03.2024 - Current

Customer Service Representative

DentaQuest Medicaid
07.2022 - 01.2024

Customer Service Representative

CareSource
06.2021 - 07.2022

High School -

Warwick High School

MEDICAL SCIENCES

ECPI University

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Kelsey Walker