Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Shakiyla Diamond

Cartersville

Summary

Results-driven professional with extensive experience in customer service, credentialing and claims management. Adept at training staff, managing escalations, and executing special projects. Focused on driving improvements in operational efficiency and enhancing team performance.

Overview

15
15
years of professional experience
1
1
Certification

Work History

Senior Coordinator lll

Walmart
Bentonville, Arkansas
08.2022 - 01.2026

• Responsible for handling technical escalations and more advanced inquiries that are beyond the skillsor knowledge of your first level customer service representatives.
• Assist drivers with handling basic troubleshooting with the app
• Help drivers with shop and delivery orders
• Assist with compensation and escalating the issue if it is not resolved
• Explaining to drivers requirements of incentives, tips, and referrals
• Helping drivers understand the rules and regulations of being a driver
• Updated payments that drivers are missing and providing next steps
• Provided next steps of deactivated accounts and filing appeals
• Closed out orders for drivers when they're having an issue doing it themselves.
• Provided phone, chat and email support
• Selected to participate in a special project focused on Trust and Safety within the delivery supportdepartment as part of my current role
• Helped train others in my current role with delivery support
• Selected to help with in a special project focused on Identity Verification within the delivery supportdepartment as part of my current role

Claims Specialist

State Farm
Atlanta, Georgia
01.2019 - 08.2022

• Investigate insurance claim to determine if it qualifies for payment under the policy
• Contact the insurer’s representative to obtain information about the claim
• Obtain all necessary documentation from the claimant and/or witnesses
• Contact third party providers such as doctors or hospitals to verify medical treatment received by the insured person
• Review the entire file to ensure that no additional payments are due
• Prepare an accurate report summarizing the investigation and findings
• Provide any other assistance requested by the insurer’s representatives
• Inform the insurer when the claim has been closed
• Keep records of all work performed in connection with the claim
• Maintain confidentiality regarding information obtained during the course of the investigation
• Follow up on outstanding issues related to the claim
• Make sure all necessary reports are completed and submitted promptly to the appropriate parties
• Evaluate the accuracy of the completed reports
• Correct any errors found in the reports
• Report to the supervisor any problems encountered while performing your duties
• Carry out negotiations of claim settlements with claimants and their attorneys
• Assist in processing new claims.

Customer Service Representative

Chime
Atlanta, Georgia
12.2017 - 01.2019

• Familiarizing yourself with and remaining up-to-date with changes in our plans and tariffs.
• Greeting customers in a friendly, professional manner using the suggested script.
• Answering telephonic and e-mail inquiries in a timely manner.
Deferring queries to your line manager if you are unable to answer them.
• Furnishing members and health care practitioners with details regarding members' benefits.
• Granting pre-authorizations for medical treatment, if covered.
• Advising members of outstanding co-payments.
Providing extant and prospective members with the details of network providers.
Canceling members' plans upon their request, or due to recurrent non-payment, if directed by your line manager.
Ensuring that your workspace remains tidy and that you are equipped with all relevant tools and resources.

Credentialing Specialist

Transcom
Sweeden, Kentucky
05.2014 - 12.2017
  • Managed credentialing processes for healthcare providers, ensuring compliance with regulatory standards.
  • Maintained accurate records and data entry for healthcare systems, ensuring completeness and consistency across the platforms.
  • Reviewed forms and supporting documents for accuracy, missing information, and compliance requirements.
  • Communicated with internal teams to resolve documentation discrepancies and meet turnaround deadlines.
  • Demonstrated strong time management and organization while supporting remote and deadline driven workflows.

Manager

Krystal
Union City, Georgia
02.2011 - 05.2014

Provide outstanding customer service across all boards.
• Cash handling.
• Maintain high levels of food safety and workplace cleanliness.
Well-versed in dealing with customer complaint resolution.
Successfully interact with the public.
Take customer orders and input them into the order machine.
• Notify kitchen staff about orders.
Serve and assemble orders for customers.
Make and serve hot beverages.
Returning and washing of dirty dishes.
• Prepare food items as needed.
Clean and organize the workplace and customer dining room.
• Training of other employees.

Handling the safe and money management.

• Deposit money via bank.

•Set a schedule for employees.

Education

High School Diploma -

Frank McClarin High
College Park, GA
05.2010

Skills

  • Managing experience
  • Customer service
  • Food safety
  • Research
  • Surveillance
  • Problem solving
  • Attention to detail
  • Data retrieval systems
  • Credentialing
  • Multitasking and organization
  • Data entry
  • CRM software
  • Discretion and confidentiality
  • HIPAA compliance
  • Background checks
  • Provider enrollment

Certification

Guard Card

Timeline

Senior Coordinator lll

Walmart
08.2022 - 01.2026

Claims Specialist

State Farm
01.2019 - 08.2022

Customer Service Representative

Chime
12.2017 - 01.2019

Credentialing Specialist

Transcom
05.2014 - 12.2017

Manager

Krystal
02.2011 - 05.2014

High School Diploma -

Frank McClarin High
Shakiyla Diamond