Customer Service Engagement Specialist

Jada Capler

Customer Service & Member Engagement Specialist Healthcare Claims & Scheduling

Expert Skilled in Patient Communication & Support Brownsburg, IN

Professional Summary

My objective is to obtain a position in a professional environment where my skills are valued and can benefit the organization. As well as working in an environment that offers a greater challenge and the opportunity to help the company advance efficiently and productively while providing exceptional customer service.

Key Qualifications:

• Experienced in handling customer inquiries per established policies

• Skilled in delivering high-quality service while maintaining professionalism

• Strong conflict resolution and critical thinking abilities

• Knowledgeable in HIPAA compliance and data privacy

• Proficient in MS Office (Excel, Word, PowerPoint)

• Collaborative team player with a strong commitment to customer care Willing to relocate: Anywhere

Authorized to work in the US for any employer

Work Experience

Customer Service Representative II – Member Services IU Health-Indianapolis, IN

June 2022 to Present

• Process incoming faxes and ensure timely and accurate routing to appropriate departments or entry into internal systems

• Respond to escalated inquiries involving claim payments, denials, and appeals with professionalism and accuracy

• Research and resolve denied claims, providing detailed updates and resolutions to providers upon request

• Maintain strict client confidentiality and uphold HIPAA standards while managing sensitive health and claims information

• Communicate coverage details clearly to members and providers, ensuring full understanding of benefits and services

• Utilize strong problem-solving and critical thinking skills to resolve complex issues in a timely manner

• Perform additional administrative and customer service duties as assigned to support team operations

• Handled inbound calls from members and providers regarding medical claims, eligibility, and coverage details

• Responded to provider inquiries regarding CPT codes, verifying whether prior authorizations (PA) were required for specific procedures

• Assisted in validating prior authorization status for procedures and ensured accurate information was relayed to healthcare providers

• Provided detailed benefit breakdowns to members, including copays, coinsurance, deductibles, and service coverage

• Verified member eligibility and assisted in confirming coverage for scheduled medical services

• Delivered high-quality, empathetic service while adhering to HIPAA and company privacy policies

• Conducted outbound welcome calls to new members, expressing appreciation for choosing IU Health Plans and informing them of available services

• Assisted members with scheduling primary care appointments to ensure timely access to healthcare providers and promote member engagement

Title Specialist

IAA-Zionsville, IN

December 2021 to June 2022

• Ensured vehicle titles were accurately sent to the appropriate state agencies

• Processed and filed paperwork to establish or transfer motor vehicle ownership

• Filed vehicle-related tax documents with the Bureau of Motor Vehicles (BMV)

• Maintained detailed records of all incoming vehicle titles

• Performed additional administrative duties as assigned to support title processing and compliance Human Services Consultant – Department of Child Services Rose International

October 2017 to December 2021

• Answered incoming calls and responded to emails regarding status updates on background checks and fingerprint submissions

• Processed background check request forms to determine whether individuals had a substantiated history of child abuse and/or neglect

• Informed subjects with findings of abuse/neglect about available options, including filing a CPS waiver when the request was made for agency purposes

• Provided information and guidance related to fingerprint-based evaluations, including eligibility for criminal waivers or next steps if ineligible

• Delivered accurate and empathetic communication while adhering to confidentiality standards and relevant regulations

• Performed other administrative and support duties as assigned to ensure efficient processing and case management

Quality Assurance Analyst

Eli Lilly-Plainfield, IN

October 2020 to September 2021

• Performed document control tasks, including filing, scanning, copying, and logging critical quality and compliance documentation

• Maintained data integrity by accurately entering and verifying quality data in systems as a data clerk

• Barcoded and cataloged documentation and materials for traceability and inventory control within the QA library

• Conducted quality assurance inspections on materials and processes to ensure compliance with company and regulatory standards

• Managed email communications related to QA documentation, inspection findings, and cross- departmental coordination

• Supported internal documentation libraries and ensured proper version control and document accessibility

Walmart E-Commerce Distribution Center –

Stocker / Receiver-Plainfield, IN

April 2020 to June 2020

• Received incoming shipments, verified contents, and organized inventory for storage

• Stocked merchandise in appropriate warehouse locations for efficient retrieval and distribution

• Conducted quality assurance (Q/A) checks to ensure products met company standards

• Maintained accurate inventory records and supported a clean, organized work environment

• Collaborated with team members to meet daily shipping and receiving goals Kohl’s Distribution

Receiver / Stocker Warehouse Associate-Plainfield, IN November 2019 to January 2020

• Accurately picked, packed, and labeled merchandise for shipment using RF scanners

• Verified container contents and destinations by scanning and cross-checking labels

• Received, stored, and prepared goods for outbound shipping in a fast-paced warehouse environment

• Applied correct shipping labels to prevent delays and ensure accurate deliveries

• Maintained cleanliness and organization of warehouse areas in compliance with OSHA safety standards

• Certified in sorting and packing procedures to support operational efficiency Assistant Store Manager

Great Value Storage-Indianapolis, IN

March 2018 to September 2019

• Handled a high volume of customer inquiries, complaints, billing issues, and service requests both in- person and over the phone

• De-escalated challenging situations, rebuilt customer trust, and provided effective problem resolution strategies

• Managed unit rentals, conducted collection calls, coordinated auctions, and oversaw unit cleanouts

• Created and managed Craigslist ads to drive occupancy and support marketing efforts

• Performed routine office tasks, including filing, copying, and thorough documentation of client records; purged files as needed

• Processed payments via credit/debit cards and cash, ensuring accuracy and adherence to company policies

• Opened and closed the store independently, including cash drawer reconciliation and daily bank deposits

• Balanced multiple customer needs in a fast-paced retail environment while delivering exceptional service

• Ensured timely and accurate implementation of rental increases

• Demonstrated and upheld company core values including respect, honesty, integrity, inclusion, and safety

Education

General Studies (High School Diploma)

Carpe Diem Innovative Northwest H. S-Indianapolis, IN August 2015 to June 2017

Skills

• Communication

• Follow up

• Documentation

• Order picking and labeling

• Ability to remain professional and objective in high-stress interactions

• Phone etiquette

• English

• Data entry and documentation

• Information analysis

• Customer-satisfaction

• Proficient in Microsoft Office Suite (Word, Excel, PowerPoint)

• Computer skills

• Customer service

• Excellent customer service and problem-solving abilities

• Payment processing

• Multi-tasking

• Assertiveness

• Self-control

• Communication skills

• Administrative support and clerical experience

• Microsoft Office

• Data entry

• Microsoft Excel

Contact this candidate