Summary
Overview
Work History
Education
Skills
Timeline
Generic

LaKenya Williams

Jackson

Summary

Professional counselor equipped to guide clients through challenges and foster personal growth. Strong background in providing emotional support, conflict resolution, and developing coping strategies. Proven ability to collaborate effectively within team to achieve impactful results. Adaptable and dependable with focus on active listening, empathy, and problem-solving skills.

Overview

16
16
years of professional experience

Work History

Grievance/Appeals/Patient Assistance Counselor

Spectraforce Technologies
02.2024 - Current
  • Demonstrated ability to manage multiple tasks while remaining adaptable and flexible.
  • Responded quickly to meet customer needs and resolve problems.
  • Committed to delivering excellent customer service while working in a fast-paced environment.
  • Analyzed and evaluated appeal cases for accuracy, completeness, and compliance with applicable laws, regulations, and procedures.
  • Assisted in developing training materials related to the grievance appeals process.
  • Reviewed documents and records related to grievances filed by employees or other claimants.
  • Reviewed and verified age, name, address and principal sum and value of property, on insurance applications, and policies.
  • Demonstrated excellent communication skills, both verbal and written, in order to effectively interact with customers.
  • Responded to telephone inquiries and complaints following standard operating procedures.
  • Analyzed data from customer surveys to identify potential areas of improvement within the organization's grievance resolution system.
  • Collaborated closely with management teams to ensure compliance with company policies related to appeals and grievances.
  • Monitored changes in relevant legislation affecting appeals processes.
  • Evaluated current systems used by the department for responding to appeals and grievances requests.
  • Conducted regular meetings with stakeholders to discuss progress on pending appeals and grievances.
  • Assisted in developing new policies and procedures related to the handling of customer disputes.
  • Provided clear communication to clients regarding their rights, responsibilities, and options throughout the appeal process.

Delivery Driver

Amazon
10.2023 - 02.2024
  • Ensured customers received their orders in a timely manner, providing excellent customer service at every opportunity.
  • Checked delivery addresses and verified correct package delivery.
  • Managed multiple tasks simultaneously while delivering goods within specified time frames.
  • Utilized GPS systems to accurately navigate routes while adhering to scheduled delivery times.
  • Developed strong relationships with customers by providing friendly service and responding to inquiries promptly.
  • Maintained set routes and schedules to meet customer expectations.
  • Adhered to delivery schedules and deadlines.
  • Loaded and unloaded delivery vehicles with accuracy, ensuring all items were accounted for.
  • Operated delivery vehicle in accordance with local traffic laws, regulations, and safety standards.
  • Confirmed all packages were properly labeled.
  • I also loaded and unloaded all packages.

Grievance and Appeals Customer Account Executive

Comcast Corporation
04.2015 - 10.2023
  • Self-motivated, with a strong sense of personal responsibility.
  • Worked effectively in fast-paced environments.
  • Demonstrated strong organizational and time management skills while managing multiple projects.
  • Organized regular meetings for the Grievance Appeals team to discuss updates, share knowledge, and address challenges collectively.
  • Displayed excellent time management skills while managing multiple high-priority cases concurrently without compromising quality or attention to detail.
  • Developed comprehensive reports analyzing trends in grievance appeals, resulting in targeted improvements to policies and procedures.
  • Assisted in policy development by providing expert insights based on experience handling complex grievances and appeals cases.
  • Enhanced grievance appeals efficiency by streamlining processes and implementing best practices.
  • Collaborated with cross-functional teams to address systemic issues identified during the grievance appeals process.
  • Implemented quality control measures that ensured accuracy in case documentation and reduced instances of rework or errors in processing claims.
  • Promoted a culture of continuous learning and development within the Grievance Appeals team, encouraging skill growth and knowledge sharing.
  • Conducted thorough investigations for complex cases, ensuring fair and accurate outcomes.
  • Improved customer satisfaction rates by providing timely and empathetic responses to appeals inquiries.
  • Maintained compliance with regulatory requirements by staying current on industry standards and guidelines.
  • Contributed to higher client retention rates through exceptional service delivery during the grievance appeals process.

Insurance/Appeals-Benefits Verification Specialist

Xerox
03.2010 - 04.2015
  • Collaborated with external providers such as health plans, pharmacies, to obtain required information for verification purposes.
  • Provided guidance to customers regarding their benefit options and eligibility requirements.
  • Analyzed customer requests to determine the appropriate action to take based on established guidelines.
  • Utilized problem solving skills to resolve complex issues related to benefit verification operations.
  • Interacted professionally with internal staff members as well as external vendors while providing excellent customer service.
  • Conducted research to verify insurance coverage eligibility, authorization and other related issues.
  • Monitored progress on all pending appeals cases ensuring timely resolution per established deadlines.
  • Researched medical records to ensure accuracy of claims processing and compliance with regulations.
  • Developed written appeals, including detailed explanation of rationale for appealing claim denials.
  • Analyzed clinical data and healthcare coding to determine potential appealable issues.
  • Organized and worked with detailed office and warehouse records, maintaining files for each policyholder, including policies that were to be reinstated and cancelled.
  • Compared information from application to criteria for policy reinstatement and approved reinstatement when criteria were met.
  • Examined letters from policyholders and agents, original insurance applications, and other company documents to determine if changes were needed and effects of changes.
  • Created reports summarizing findings from investigation interviews with all relevant parties involved in a grievance case.
  • Developed policies and procedures related to the processing of grievances.

Cashier

Walmart
04.2009 - 03.2010
  • Operated cash register and accurately processed payments, returns, and exchanges.
  • Maintained cleanliness of the checkout area by cleaning counters, shelves and windows.
  • Performed opening and closing procedures, such as counting cash register, restocking, and cleaning.
  • Built and maintained positive working relationships with co-workers.
  • Demonstrated excellent customer service skills while interacting with customers in a friendly manner.
  • Provided excellent customer service by greeting customers and offering assistance.
  • Helped restock shelves when necessary to maintain an organized display area.
  • Developed strong customer service skills by providing efficient and accurate service.
  • Accurately processed customer payments using cash, credit cards, and checks.
  • Managed large amounts of cash accurately during busy hours in a fast-paced environment.
  • Provided efficient and courteous service to customers.
  • Developed strong customer relationships to support satisfaction and loyalty.
  • Handled customer complaints and inquiries in a courteous and efficient manner.
  • Counted and balanced cash drawer at the beginning and end of each shift.
  • Utilized problem solving skills to effectively handle difficult situations.
  • Assisted with training and mentoring new team members.
  • Delivered exceptional customer service at all points of contact.
  • Greeted and informed customers of products, fostering positive store experiences.
  • Processed customer orders and ensured the accuracy of their purchases.

Education

High School Diploma -

Provine High School
Jackson, MS
06.2010

Skills

  • B2B Sales
  • Independent Problem Solver
  • Data Entry
  • Clerical experience
  • Product Knowledge
  • Sales Management
  • Salesforce
  • CRM Software
  • Type 35 WPM
  • Excellent Written & Verbal Communication
  • Typing
  • Upselling
  • Dispatching
  • Time Management
  • Leadership
  • Cash handling
  • Superb Customer Service
  • Account Management
  • Business Development
  • Cold Calling
  • Data analysis skills
  • Quality assurance
  • Software troubleshooting
  • Process improvement
  • Risk management
  • Mentoring
  • Data visualization
  • Computer literacy
  • Proficient in computer systems such as CSG
  • Einstein 360
  • Microsoft
  • Employee Development
  • Mentor
  • Microsoft office
  • Customer relations
  • Flexible and adaptable
  • Customer service
  • Teamwork and collaboration
  • Friendly, positive attitude
  • Multitasking
  • Time management

Timeline

Grievance/Appeals/Patient Assistance Counselor

Spectraforce Technologies
02.2024 - Current

Delivery Driver

Amazon
10.2023 - 02.2024

Grievance and Appeals Customer Account Executive

Comcast Corporation
04.2015 - 10.2023

Insurance/Appeals-Benefits Verification Specialist

Xerox
03.2010 - 04.2015

Cashier

Walmart
04.2009 - 03.2010

High School Diploma -

Provine High School

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LaKenya Williams