Escense Williams
Atlanta
Summary
Experienced healthcare and customer service professional skilled in insurance verification, prior authorizations, and care coordination. Proficient in navigating insurance policies, collaborating with teams, and ensuring compliance while delivering optimal patient outcomes in fast-paced environments.
Overview
3
3
years of professional experience
Work History
Customer Care Coordinator - Prior Authorizations
Evolent
07.2024 - 04.2025
- Assisted healthcare providers and members with navigating prior authorization requests, ensuring compliance with payer policies
- Maintained meticulous documentation to streamline insurance claims and secure reimbursements
- Coordinated with internal teams to address discrepancies in eligibility, coverage, and authorization status
- Monitored authorized clinical days and reconciled with patient care to optimize reimbursement processes
Behavioral Health Advocate
Cigna Healthcare, Evernorth Behavioral Health
04.2025 - 08.2025
- Consistently maintained accurate records and documentation, contributing to improved communication among members of the client''s care team.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
- Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
- Provide eligibility information for to providers
- Insurance Verification.
Member Services Representative
Kaiser Permanente
10.2023 - 05.2024
- Verified insurance eligibility and benefits, ensuring accuracy in member records
- Resolved claims-related concerns and provided members with information on covered services
- Facilitated collaboration between members and healthcare providers for seamless service delivery
Customer Service Representative
Get Insured
05.2022 - 12.2023
- Assisted customers in navigating insurance policies and resolving inquiries related to billing and claim
- Supporting insurance brokers with client onboarding and administrative task
- Maintaining broker-specific records and documentation, ensuring accuracy and compliance
- Communicating with team members and other departments to ensure prompt and efficient
Education
Bachelor of Arts - Psychology
Clark Atlanta University
05.2022
Skills
- Insurance Verification and Authorization
- Healthcare Case Management Support
- Coordination of Benefits (COB)
- Payer Relations and Reimbursement Strategies
- Multitasking and Time Management
- HIPAA Compliance and Documentation Accuracy
- Effective Communication and Collaboration
- Microsoft Office Suite
- Case Management Systems
- Insurance and Healthcare Portals
Timeline
Behavioral Health Advocate
Cigna Healthcare, Evernorth Behavioral Health
04.2025 - 08.2025
Customer Care Coordinator - Prior Authorizations
Evolent
07.2024 - 04.2025
Member Services Representative
Kaiser Permanente
10.2023 - 05.2024
Customer Service Representative
Get Insured
05.2022 - 12.2023
Bachelor of Arts - Psychology
Clark Atlanta University
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