En'Joli Williams
Sacramento,CA
Summary
Compassionate and attentive Support Clerk with a diverse background in social services, child support, customer care, and healthcare. Utilizing well-researched references, successfully connecting individuals with valuable community resources. Dedicated Specialist advocating for underrepresented communities. Over 5 years of expertise as a Member Services Representative in high-pressure customer service and call center environments. Known for personable and professional approach. Excels at maintaining composure under pressure and has a strong desire for continuous professional growth and new opportunities.
Overview
5
5
years of professional experience
Work History
Eligibility Support Clerk (ESC)
Alameda County Social Services Agency
07.2024 - Current
- Input and manage Medi-Cal eligibility data on the State-directed MEDS Network and Case Database for individuals referred by the Social Services Agency
- Review, verify, and process MEDS Network request forms submitted by authorized staff, ensuring accuracy and compliance
- Activate and modify Medi-Cal and Food Stamps eligibility records, creating a comprehensive statewide index in the MEDS Network
- Enter benefits information into the system to establish Food Stamps history and facilitate program access
- Create and issue immediate need Medi-Cal cards and Electronic Benefit Transfer (EBT) labels for state eligibility recipients, including those receiving Social Security benefits
- Process replacement requests for permanent EBT cards, ensuring timely and accurate distribution
- Conduct research to verify that clients are not receiving benefits in multiple counties, ensuring compliance with eligibility requirements
- Handle routine inquiries regarding case histories, providing accurate responses to internal requests
- Confirm all data entries in the MEDS Network and alert investigative staff to potential fraudulent situations
Telephone Service Agent (TSA)
Fortuna BMC
10.2023 - 05.2024
- Served as the primary point of contact for members, providers, and vendors, addressing inquiries and concerns
- Provided detailed information on claims, benefits, authorizations, pharmacy authorizations, and member eligibility
- Offered updates on prior authorization statuses and assisted members in understanding and navigating the appeal process for coverage decisions
- Resolved incoming calls regarding member eligibility, benefits, and Managed Care Plan (MCP) details, ensuring timely and accurate support
- Demonstrated adaptability by quickly learning new systems, tools, and procedures as needed for optimal performance.
- Utilized strong communication skills to effectively address customer concerns and provide solutions that met their needs.
- Managed approximately 30-50 calls per day.
Case Specialist
Alameda County DCSS
05.2022 - 06.2023
- Documented case updates, including customer demographics, case actions, history logs, and records, ensuring accurate and thorough information tracking
- Stayed current with quality standards, regulations, and policies to maintain compliance, consistency, and high-quality service
- Prepared various forms of communication, including letters, emails, memos, and documents, to verify or obtain necessary information for processing child support cases
- Utilized appropriate methods and procedures to locate absent parents and gather information on participant assets, income, and liabilities
- Contacted other agencies and utilized web-based searches, government records, and databases to gather relevant information and support case processing
Member Service Representative
Wollborg Michelson
11.2021 - 04.2022
- Coordinated membership changes, including updates to primary care physicians, and handled routine mid-level member inquiries
- Initiated, reviewed, and analyzed claims for accuracy, ensuring proper benefits application
- Educated members on benefits, coverage denials, formulary alternatives, and prescription information
- Delivered customer service through multiple channels (phone, live chat, and email) in a fast-paced contact center environment
- Participated in quality and efficiency workgroups aimed at improving member satisfaction and service outcomes
- Demonstrated thorough understanding of insurance policies, medical terminology, and benefit procedures.
- Applied knowledge of charity care and government/non-government programs
- Assisted with financial payment requests, calculations, and processing, including basic math for payment accuracy
- Utilized intermediate to advanced computer skills for claims management and customer interactions
- Handled incoming high call volume 30-40 calls per day.
Administrative Support Specialist
Alameda Employee Retirement Association
01.2020 - 10.2021
- Assisted in the development and preparation of notices, agendas, and other materials for meetings of the Retirement Board of Trustees
- Attended and recorded minutes for all regular and special committee/subcommittee meetings, ensuring accuracy and clarity in documentation
- Edited drafts for composition, grammatical structure, and consistency to ensure professional quality
- Coordinated staff meetings, obtaining additional data as needed from individuals, groups, or members
- Interpreted administrative decisions and policies regarding retirement-related matters, providing clear communication to staff and members
- Independently referred more technical issues to appropriate staff for further research or resolution
- Provided secretarial support to the Retirement Association Executive Management Team, ensuring efficient office operations and communication
- Prepared a wide range of written materials, including letters, memos, procedures, and other documents
- Entered information into multiple databases and accessed various data sources to prepare comprehensive materials and reports
Education
Bryman College
Hayward, CA08.2003
Skills
- Time management
- Communication skills
- Customer service
- CRM
- Microsoft Office
- Project Management
- Microsoft Outlook
- Microsoft Word
- Health Insurance Portability & Accountability Act
- Problem Resolution
Timeline
Eligibility Support Clerk (ESC)
Alameda County Social Services Agency
07.2024 - Current
Telephone Service Agent (TSA)
Fortuna BMC
10.2023 - 05.2024
Case Specialist
Alameda County DCSS
05.2022 - 06.2023
Member Service Representative
Wollborg Michelson
11.2021 - 04.2022
Administrative Support Specialist
Alameda Employee Retirement Association
01.2020 - 10.2021
Bryman College
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