Ja'Keria English
Columbus
Summary
Professional with strong background in claims management, prepared to make significant impact. Skilled in assessing and processing claims accurately, resolving complex issues, and ensuring customer satisfaction. Effective team collaborator with focus on achieving results and adapting to changing needs. Known for analytical thinking, communication skills, and attention to detail.
Analytical problem-solver with excellent communication skills. Effective at interviewing claimants, compiling records and documenting findings. Well-versed in insurance policies, practices and standards.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Claims Customer Service Representative
Aflac
Columbus, GA/ Remote
09.2025 - Current
- Processed and analyzed claims with attention to accuracy and compliance with policies.
- Communicated effectively with clients to resolve inquiries and provide claim status updates.
- Collaborated with internal teams to streamline claims processing workflows, enhancing efficiency.
- Trained and mentored junior staff on claims procedures and best practices for customer service.
- Implemented quality assurance measures to elevate service standards and operational efficiency.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Exceeded performance metrics consistently, earning recognition as a top performer within the team.
Benefits Onboarding Specialist
Apex Systems (Gusto Contact)
Phoenix, AZ/ Remote
08.2024 - 09.2025
- Oversee the entire benefits onboarding process from start to finish, ensuring timely delivery of services in collaboration with cross-functional teams.
- Provide healthcare and benefits enrollment expertise via written and verbal communication with Gusto customers.
- Work directly with clients to implement customized employee benefits packages.
- Offer guidance, manage escalations, and support customers during key moments in their benefits journey.
- Manage multiple priorities and tasks using Salesforce and other technology platforms.
- Respond to customer inquiries via phone, chat email, delivering exceptional service throughout the onboarding process.
Rehabilitation Specialist
Southwest Network
Phoenix, AZ
12.2023 - 08.2024
- Oversee and manage onboarding processes for clients, ensuring seamless integration into day programs and community-based activities.
- Collaborate with cross-functional teams to develop and implement individualized care plans.
- Provide administrative supervision and rehabilitation support for individual, group, and case management services.
- Guide clients through healthcare and benefits options, fostering understanding and adherence to treatment plans.
- Utilize client-centered approaches to improve emotional regulation, communication skills, and medication adherence.
- Maintain meticulous documentation in compliance with state, federal, and agency standards.
Program Supervisor & Onboarding Specialist
Arizona Mentor
Phoenix, AZ
02.2021 - 12.2023
- Managed healthcare service delivery and compliance with all licensing requirements.
- Partnered with clients to design personalized benefits and behavioral health plans, ensuring smooth onboarding.
- Trained new hires in policies, procedures, and certifications, including CPR and First Aid.
- Maintained detailed client and staff records using tools like Salesforce for compliance and efficiency.
- Designed and monitored treatment plans, ensuring alignment with client goals and healthcare needs.
- Supported clients and groups during their transition into care programs, and all benefits and programs; ensuring all onboarding tasks were completed accurately.
Program Supervisor & Onboarding Specialist
Georgia Mentor
Actworth, GA
08.2017 - 02.2021
- Managed healthcare service delivery and compliance with all licensing requirements.
- Partnered with clients to design personalized benefits and behavioral health plans, ensuring smooth onboarding.
- Trained new hires in policies, procedures, and certifications, including CPR and First Aid.
- Maintained detailed client and staff records using tools like Salesforce for compliance and efficiency.
- Led day-to-day operations for healthcare service delivery, ensuring full compliance with state and federal licensing regulations.
- Oversaw multidisciplinary teams to maintain adherence to quality assurance protocols and individualized care standards.
Education
Master of Science - Business Analytics (MSBA)
Grand Canyon University
Phoenix, AZ05-2028
Bachelor of Science - Human Relations
Rio Salado College
Tempe, AZ05-2021
High School Diploma - undefined
Lithia Springs High School
Douglasville, GA05-2016
Skills
- Client-Facing Support
- Salesforce Proficiency
- Problem Solving & Decision Making
- Cross-Team Collaboration
- Process Improvement
- Written & Oral Communication
- Adaptability
- Benefits Administration
- EMAR Proficiency
- Documentation Proficiency
- CRM Software (Salesforce, Zendesk, Freshdesk)
- Help Desk Ticketing Systems
- Multichannel Communication (phone, email, live chat, social media)
- Interpersonal communication
- Decision-making
- Documentation review
- Conflict resolution
- Insurance regulations
- Claims processing
- Customer service
- Active listening
Certification
- CPR, First Aid, Basic Life Support (BLS)
- HIPAA Compliance
- Article 9 Certification
- Crisis Intervention and Prevention (CPI)
- Level 1 Fingerprint Clearance
- Certified Personal Medical Coach (Est: May 2024 PaDegan)
Timeline
Claims Customer Service Representative
Aflac
09.2025 - Current
Benefits Onboarding Specialist
Apex Systems (Gusto Contact)
08.2024 - 09.2025
Rehabilitation Specialist
Southwest Network
12.2023 - 08.2024
Program Supervisor & Onboarding Specialist
Arizona Mentor
02.2021 - 12.2023
Program Supervisor & Onboarding Specialist
Georgia Mentor
08.2017 - 02.2021
High School Diploma - undefined
Lithia Springs High School
Master of Science - Business Analytics (MSBA)
Grand Canyon University
Bachelor of Science - Human Relations
Rio Salado College