Customer Service Representative
Resume:
KAFILAT SALAMI
Kafilatsalami*@gmail.c
EDUCATION
Bachelor of Science
The University Of Texas Arlington
TX
Associate
Hillsborough Community College
Tampa, FL
SKILLS
MENTORING
TRAINING
Safety
Effective custom
Communication
Issue identification a
Resolution
CRM and office managem
Software
Proposal writing
Meeting planning
Mail management
Work ethic
Time Management
Data management
CAREER OBJECTIVE
Dedicated administrative assistant with solid background in high-volume off environments focused on delivering exceptional clerical and operational support for professionals. Energetic professional with strong judgment and a track record in managing office tasks, paperwork, and projects with minimal oversight. Experienced Customer Service Representative skilled in sales, account management, and addressing diverse customer needs. Knowledgeable in insurance products, problem-solving, and handling complex issues.
Proven Project Coordinator with a focus on team productivity, delivering projects on time and under budget. Experienced in SAP business structures, system updates, and software solutions. Skilled SAP Consultant with expertise in market trends, promoting innovation, and providing technical training. WORK EXPERIENCE
prior authorization specialist
CVS CAREMARK
05/2023 - 12/2024 Remote
Enhanced client satisfaction by addressing concerns promptly and providing exceptional service.
Built customer loyalty and retention by delivering excellent shopping experiences.
Achieved top performer status consistently through dedication to meeting goals and exceeding expectations.
Used in-store systems to locate inventory and place special orders for customers.
Implemented feedback loops that encouraged continuous improvement among team members by sharing insights about exceptional service delivery techniques.
Educated customers about billing, payment processing and support policies and procedures.
Developed customer service policies and procedures to meet and exceed industry service standards
Customer Service Representative(PA)
weightwatchers
06/2021 - 04/2023 Remote, TX
Updated details in the company database by keying in customer contacts. Hardware Installation and Maintenance.
Maintained accurate and up-to-date records of all authorization requests, decisions, and follow-up actions in company databases and systems.
Collaborated with healthcare providers, clinical staff, and internal teams (e.g., Member Services, Claims) to resolve complex cases and improve overall service delivery.
Conducted employee onboarding and helped organize over 1K hours of training and development initiatives
Collaborated with leadership on recruitment strategies, development plans, performance management, and employee engagement to improve retention rates by 12%
Managed company organizational structure, responsibilities, and staff levels, creating strong hierarchy channels Scheduled interviews for candidates across 30 roles Led new talent acquisition and recruitment processes Prior Authorization Associate
Humana
07/2019 - 04/2021 Remote, TX
Reviewed and processed prior authorization requests for medical treatments, medications, and procedures to ensure compliance with Humana's policies and clinical guidelines.
Assessed the medical necessity of services based on submitted documentation and made approval decisions in accordance with insurance guidelines.
Communicated authorization decisions and requested additional information from healthcare providers and patients when needed, ensuring a clear and timely process.
Assisted in the appeals process by reviewing denied authorizations, investigating the reasons for denial, and facilitating reevaluations when appropriate.
Monitored pending authorizations and followed up with providers and members to ensure timely processing and resolution of requests. Stayed current on Humana’s policies, government regulations, and clinical guidelines to ensure compliance and accurate decision-making.
Prior Authorization specialist
MDlive
07/2018 - 01/2020 Remote, TX
Processed prior authorization requests for telehealth services, ensuring compliance with MDLive’s guidelines and insurance requirements.
Reviewed medical records and documentation to assess medical necessity and collaborated with providers to resolve discrepancies. Communicated authorization decisions to providers and patients in a timely manner.
Managed follow-ups on denied or incomplete requests and facilitated appeals when necessary.
Documented and tracked all prior authorization activities using MDLive’s systems.
Stayed informed on telemedicine insurance policies and regulations to ensure accurate processing.
Contact this candidate