Danielle Willis
Douglasville
Summary
Experienced with handling patient inquiries and providing support in healthcare setting. Utilizes strong communication skills and empathy to resolve issues and ensure patient satisfaction. Knowledge of healthcare protocols and procedures, contributing to efficient and effective service delivery.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Member and Provider Service Representative
WellSense Health Plan
07.2024 - Current
- Address diverse inquiries including benefit questions, processing and denied claims, appeal and grievances, and prior authorizations request boosting provider satisfaction
- Respond to a high volume of incoming calls from members and providers (call length can vary widely, from five minutes to 45 minutes or more)
- Scheduling appointments, assigning and locating specialist and primary care doctors for members
- Maintain knowledge of WellSense contracts and policies and effectively interpret information
- Employ strong interpersonal skills to handle difficult calls courteously and professionally
- Document calls in accordance with departmental policies
- Work with peers to solve problems and promotes teamwork
- Meet or exceed department’s quality and productivity goals
Customer Service Representative
Blue Cross and Blue Shield
08.2021 - 11.2023
- Receive customer inquiries via phone, fax, mail, e-mail, etc regarding enrollment, member information, billing, primary care, benefits, claims, prior authorizations, and appeals, etc.
- Review computer systems and/or other reference materials to complete verification process
- Utilize available resources to quickly and efficiently resolve or redirect inquiries in accordance with prescribed departmental process.
- Accurately document customer inquiries and actions taken in accordance with departmental quality guidelines to ensure appropriate follow up.
- Follow up on unresolved issues in a timely manner, escalating call trends to management.
Customer Service Manager
Lowe's Home Improvement
10.2015 - 05.2019
- Train new cashiers, provide ongoing coaching, and ensure all cashiers are following company procedures and providing excellent customer service
- Process sales transactions, returns, and refunds, manage cash drawers, and ensure the checkout area is adequately stocked and organized.
- Assist customers with inquiries, handle complaints, and provide information on products, promotions, Lowe's programs, monitoring the self-checkout area, assisting with loss prevention, and ensuring the front end is a safe environment for both customers and employees.
- Open and close the store, including preparing registers, securing cash, and ensuring the front end is ready for the next shift.
Style Advisor
Justice For Girls
05.2012 - 01.2015
- Greeted customers by offering personalized fashion advice, and helping them find items that suit their needs and preferences.
- Product knowledge of staying informed about current fashion trends, new arrivals, and the specific merchandise available at Justice.
- Assisted customers with purchases, processing transactions, and potentially helping with online or mail orders.
- Maintained a clean, organized, and visually appealing store environment, potentially including tasks like folding clothes and arranging displays
Education
Certificate - Certified Clinical Medical Assistant (CCMA)
University of West Georgia
Carrollton, GA12-2025
Bachelor of Science - Journalism And Mass Communication
University of West Georgia
Carrollton, GA05.2019
No Degree - Journalism And Mass Communication
Jacksonville State University
Jacksonville, AL04.2018
Skills
- HIPAA compliance
- Insurance verification
- Patient confidentiality
- Patient scheduling
- Medical terminology
- Data entry
- Claims processing
- Medical billing
- Verbal and written communication
- Quality assurance
Certification
- CCMA - Certified Clinical Medical Assistant (In Progress)
Timeline
Member and Provider Service Representative
WellSense Health Plan
07.2024 - Current
Customer Service Representative
Blue Cross and Blue Shield
08.2021 - 11.2023
Customer Service Manager
Lowe's Home Improvement
10.2015 - 05.2019
Style Advisor
Justice For Girls
05.2012 - 01.2015
Certificate - Certified Clinical Medical Assistant (CCMA)
University of West Georgia
Bachelor of Science - Journalism And Mass Communication
University of West Georgia
No Degree - Journalism And Mass Communication
Jacksonville State University
Similar Profiles
Kimberly CavettKimberly Cavett
Supplier Relationship Manager Senior at WellSense Health PlanSupplier Relationship Manager Senior at WellSense Health Plan
Kishia ArmstrongKishia Armstrong
SOC Care Manager at Wellsense Health PlanSOC Care Manager at Wellsense Health Plan
Ophelia GibsonOphelia Gibson
Data Analyst at WellSense Health PlanData Analyst at WellSense Health Plan
Lily MaxcyLily Maxcy
Teacher at Douglas County SchoolsTeacher at Douglas County Schools
Sasha SandersSasha Sanders
Claims Specialist - Intermediate at Progressive InsuranceClaims Specialist - Intermediate at Progressive Insurance