Customer Service & Admissions Specialist

Shiquawana Rainey

Jacksonville, FL ***** +1-904-***-**** ****.******@*****.***

Willing to relocate to: Duval County, FL - Jacksonville, FL Work Experience

Member Service Representative

Capital Blue Cross-contract Jacksonville, FL

December 2025 to Present

• Explaining Healthcare Plans

• Researching providers

• Verifying mail order prescriptions

• Generating duplicate member ID cards

• Discussing claims denied and approved

• Approving pre authorizations

• Submitting pre authorizations

• discussing differences between PPO &- HMO

• Verifying benefits

• Processing Claims

• Setting appointments and scheduling pick ups

• Processing monthly premium payments

• Creating invoices

• EOB

• Researching prescriptions on companies formulary list

• Researching CPT and Diagnosis Codes

Admissions Representative

Ultimate Medical Academy Jacksonville, FL

January 2023 to Present

• Interviewing potential students

• Walking through enrollment process

• Assisting with logging in and out of online portals

• Providing Accrediting and Licensing information

• Assisting students with Orientation and setting up for successful career path

• Assisting students to log in on FAFSA website

• Providing guidance to meet lifelong career goals Member Service Representative

Navy Federal Credit Union-Contract Jacksonville, FL April 2025 to December 2025

1. Assisting members with account questions inquiries and concerns 2. Processing payments

3. Submitting Disputes

4. Handling Fraud Claims

5. Loan applications

6. Enrolling members into mobile banking

7. Setting up Debit and Credit Cards

8. Property Verifying members

9. Assisting with loan and credit card payments

10. Researching checks and deposits

Picker/Packer

BENEFIT COSMETICS / Ulta Beauty Jacksonville, FL October 2022 to January 2023

• Picking

• Packing

• Loading/Unloading

• Pushing carts

Inbound Correspondence Processor

Radius Global Solutions LLC

December 2021 to October 2022

• Reading and responding to correspondences

• Updating account statuses

• Searching different platforms

• Tracking info on systems

• Sending out bill reminders

• Handling disputes

• Updating bankruptcy statuses/chapters

• Collections

Security Officer

Allied Universal

August 2021 to March 2022

• Observe and report

• Daily log

• Incident reports

• Monitoring all floors in building

• Checking badge swipes

• Checking Covid status

• Issuing Covid Test every 3 days

• Watching video surveillance

• Greeting Employees/ Visitors

SPOC

Freedom Mortgage

August 2020 to November 2021

• Inbound calling

• Follow ups

• Scheduling call backs

• Explaining Escrow &- Mortgage Payments

• Finding Programs to assist with paying mortgage

• Processing payments

• Outbound calls

• Collecting on accounts 45+ days delinquent

Customer Service Representative

ADT Security Services Jacksonville, FL

May 2017 to August 2020

• Inbound calling

• Outbound calling

• Bill Specialist

• Process Payments for 90 day delinquent accounts

• Financial Support for at risk collection customers

• Technical Support

• Processing and post dating payments

• Researching/Scheduling with outside collection agencies for payment arrangements

• Explains bill history and transactions

• retention

• offering deals to retain customers

• Relocation

• Over the phone installations

• Schedule moves

Call Center Rep

Convergys Corp Jacksonville, FL

September 2016 to May 2017

-Inbound calling

-Outbound calling

-Enrolling members

-Scheduling call backs

-Explaining Medicare and Medicaid plans

-Assisting members with receiving daily meds

-Taking payments via phone

-Program eligibility

-Explanation Of Benefits

Assistant Manager

Circle K Jacksonville, FL

March 2016 to September 2016

-Assist store manager with daily store activities

-Assist with bank functions, and daily reports

-Oversee the store in absence of the store manager

-Open and or close daily and weekend shifts for the store manager as assigned

-Lock and unlock the store when necessary in the morning, evenings and closing

-Assist with scheduling, and assigning duties to store employees Lead CSR

Circle K Jacksonville, FL

April 2015 to March 2016

-Train, direct and instruct the daily performance of the office staff

-Coordinate training, meetings, and daily schedules for office staff

-assist the store manager with daily store activities

-Assign and schedule daily duties to store employees Care Manager

Sunrise Senior Living Jacksonville, FL

April 2013 to April 2015

• Support and coordinate mental healthcare within the facility

• Lift and bathe residents and or change incontinence products

• Take and or monitor blood pressure on residents

• File charts and medical history files

• Triage calling at front desk

• Transport patients to and from

Education

Business Management (Bachelor of Science)

ITT Technical Institute-National City

February 2015 to June 2016

Medical (Diploma)

Kaplan College

2014

Mathematics (High school diploma)

Englewood High School

August 2009 to June 2012

Upper secondary education

Skills

Loan application intake Microsoft Outlook Customer support experience within education industry Security License (D) Microsoft Office Loan evaluation Customer inquiry handling Objection handling (sales technique) Sales pipeline management Warehouse experience Ethernet Insurance verification Clear language communication FRONT DESK (2 years) Deal closing Writing skills Mortgage servicing Typing Banking Investor customer service experience Warm calling Customer retention CRM system proficiency Customer support specialist experience Email customer support CSR Home care Phone call management Technical troubleshooting support Cold Calling Call center experience Microsoft Teams Customer service Managing teams in a customer support role - Largest customer support team managed (1-5 team members) Skype Contracts Data entry In-person customer service Document review Negotiation Client communication Customer support experience within healthcare industry Food handling Remote technical support Triage Customer relationship management Mortgage lending Service scheduling Medical records Claim processor Call Center Customer complaint resolution Filing Patient interaction Government agency customer support Vital Signs Counter-negotiation Active listening Security Multitasking Communication skills Appointment scheduling Senior care Customer communication Retail sales Debt collection negotiation Revenue targets Initial Contact (sales skills) Task prioritization Customer service manager experience Phone etiquette Attention to detail Collector IT Sales Event scheduling Phone communication Interpersonal communication Medical Office Experience Vital signs Managing customer accounts Analysis skills Technical support Providing product information Medical Records Call center agent experience Driving Mortgage services Front desk Surveillance Finance B2B sales Windows Debt collection payment plan Store management Financial concepts Client interaction via phone calls Dispatching Telemarketing Microsoft Excel Client relationship development Computer literacy Customer returns handling Achieving sales targets Regulatory compliance Healthcare management Manager experience Time-based sales targets Building rapport Medical collection Time management Customer issue escalation Account management Computer skills Zendesk Customer support - Customer support experience (6-10 years) Live chat Assisted living Cash handling Outbound calling Patient Care Order inquiry handling Research Order picking Customer support experience within hospitality industry Billing issue inquiries Technical Proficiency Phone answering Order processing Phone customer support Math Organizational skills Technical support representative experience HIPAA Documentation review Large insurance company experience

Languages

English - Fluent

Certifications and Licenses

Guard Card

Driver's License

October 2022 to December 2024

Class D Security

August 2021 to August 2024

Additional Information

Authorized to work in the US for any employer

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