LaShawnda Dickens-Burns
Torrance
Summary
Dedicated Customer Service Specialist combined with seasoned Utilization Management Specialist, experienced in optimizing patient care and enhancing resource allocation in healthcare and insurance sectors. Achieved improved quality of care through effective utilization review procedures, regulatory compliance, and strategic cost management. Focused on leveraging training and professionalism to contribute to organizational growth and longevity.
Overview
21
21
years of professional experience
6
6
years of post-secondary education
Work History
Utilization Management
Elevance Health
Woodland Hills
05.2023 - Current
- Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests.
- Conducted clinical screening process to assess eligibility and determine necessary authorizations for services.
- Authorizes initial set of sessions to provider.
- Identified and entered referral requests into the UM system according to the plan certificate.
- Refers cases requiring clinical review to a Nurse reviewer.
- Ensured accurate benefit information was provided to clients for facility-based treatment, facilitating informed decision-making.
- Responds to telephone and written inquiries from clients, providers and in-house departments.
- Developed and maintained positive customer relations, coordinating with various functions to ensure timely and appropriate handling of customer requests and inquiries.
- Associates in this role are expected to have the ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers. Proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment.
- Strong verbal and written communication skills, both with virtual and in-person interactions.
- Attentive to details, critical thinker, and a problem-solver.
- Demonstrates empathy and persistence to resolve caller issues completely.
- Comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts.
Customer Support Specialist
Wells Fargo Phone Bank 2
El Monte
04.2018 - 05.2023
- Assisted customers in achieving financial success by assessing needs and providing options such as internal refinance, deferments, due date changes, and mutually beneficial payment plans while adhering to policy and procedure guidelines.
- Handled escalated calls, ensuring timely resolution of complex customer concerns.
- Provided technical support to customers by responding to inquiries and resolving issues in a timely manner.
- Collaborated with team members to streamline service processes, resulting in an enhanced customer experience.
- Identified and recommended improvements to existing support processes to enhance service delivery.
- Developed innovative strategies to improve customer experience with the product or service offered by the company.
- Successfully met and achieved all QA monitors, compliance, production and performance goals while remaining FDCPA compliant.
Senior Collections Specialist
Wells Fargo Dealer Services
Irvine
10.2016 - 04.2018
- Successfully meet and achieve all QA monitors, compliance, production and performance goals while remaining FDCPA compliant.
- Managed collections for delinquent accounts to ensure timely payments.
- Analyzed customer payment histories to identify collection trends and patterns.
- Negotiated repayment plans with customers to support timely payments.
- Assisted customers in achieving financial stability by assessing needs and offering solutions such as refinance options, deferments, due date changes, and mutually beneficial payment plans while adhering to policy and procedure guidelines.
- Developed and maintained relationships with customers to facilitate the collections process.
- Created strategies to lower delinquency rates across portfolios, enhancing overall collections effectiveness.
- Collaborated with internal teams to resolve account disputes efficiently.
- Adhered to all federal, state, and local laws governing debt collection practices.
- Provided guidance and training to junior staff members in the Collections Department.
- Mentored junior staff on best practices in collections and customer service.
Customer Sales & Service Specialist
Best Buy
Lakewood
10.2013 - 10.2017
- Collaborated with management team to discuss weekly/monthly sales and product highlights, exceeding sales goal to maximize monthly bonus and recognized for $20k in sales within 3 months.
- Oversaw register area, greeting customers warmly to enhance their shopping experience.
- Responded to telephone and in-person requests for information and customer concerns.
- Took online training to master roles and expand knowledge of multiple Best Buy departments.
- Prepared and distributed documents for higher management, ensuring timely communication and operational support.
Teller
Wells Fargo Bank
Long Beach
07.2015 - 10.2016
- Completed daily paperwork and printed reports for managers, ensuring accurate tracking of store performance.
- Achieved gold in sales for quarters 3 & 4.
- Kept a clean and organized cash drawer to minimize risks of loss and loss exposure.
- Assessed customer needs to provide tailored financial advice, supporting their financial success.
- Achieved gold sales status for third and fourth quarters by implementing effective sales strategies.
- Mentored new tellers and facilitated understanding of procedures and policies, enhancing team knowledge.
Special Education Teacher's Aide
Delta T-Group
Los Angeles
05.2005 - 10.2013
- Supported students with Autism/Asperger's in developing speech, reading, writing, and life skills.
- Assisted teachers in implementing individualized education plans for students.
- Supported students with Autism/Asperger in developing speech, reading, writing, and life skills.
- Collaborated with special education staff to develop engaging lesson materials.
- Supported classroom management to create a positive learning environment.
Education
Loss Prevention Agent -
Security Retail Group
Norwalk, CaliforniaRegistered Nurse -
Antelope Valley College
Lancaster, California 06.2008 - 06.2010
Certified Medical Assistant -
Career College of America
South Gate, CaliforniaHigh School Diploma -
Thomas Riley High
Los Angeles, California 06.1996 - 06.2000
Skills
- Clinical assessment
- Computer proficient
- Attention to detail
- Time management
- Results-oriented
- Problem solving
- Organizational skills
- Multitasking
- Prioritizing skills
- Ability to work in a fast-paced environment
- Verbal communication
- Written communication
- Self-directed
Accomplishments
- Received award for winning Regional iCare call.
- Service excellence for time management and Monthly Customer Compliments.
Timeline
Utilization Management
Elevance Health
05.2023 - Current
Customer Support Specialist
Wells Fargo Phone Bank 2
04.2018 - 05.2023
Senior Collections Specialist
Wells Fargo Dealer Services
10.2016 - 04.2018
Teller
Wells Fargo Bank
07.2015 - 10.2016
Customer Sales & Service Specialist
Best Buy
10.2013 - 10.2017
Registered Nurse -
Antelope Valley College
06.2008 - 06.2010
Special Education Teacher's Aide
Delta T-Group
05.2005 - 10.2013
High School Diploma -
Thomas Riley High
06.1996 - 06.2000
Loss Prevention Agent -
Security Retail Group
Certified Medical Assistant -
Career College of America