Open to opportunities

Janeia Powell

@janeiapowell

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Customer service professional specializing in healthcare claims and benefits resolution.

Zimbabwe

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What I'm looking for

I seek a customer-focused role in healthcare or insurance to apply claims and benefits expertise, use CRM/EHR tools, deliver high CSAT, and grow in a supportive, process-driven team.

I am a customer service professional with extensive experience resolving claims and benefit inquiries across healthcare and insurance settings, consistently delivering timely, accurate solutions. I have routinely handled 50–60+ daily inquiries and contributed to a 95% resolution rate and 100% CSAT on quarterly surveys.

I am proficient with CRM systems and tools including Facets and EPIC EHR, and skilled in prior authorization, FMLA administration, and HIPAA-compliant member communications. I bring strong problem-solving, multitasking, and provider-coordination abilities that reduce processing delays and improve member experience.

Experience

Work history, roles, and key accomplishments

Customer Service Agent II

Sutter Health

Jan 2022 - Jan 2024 (2 years)

Managed 60+ daily calls on coverage, prior authorization, and provider updates, ensuring HIPAA compliance and using Facets to verify enrollment, maintaining a 98% first-contact resolution and 100% CSAT.

Facets HIPAA Customer Service Enrollment Verification Provider Relations EOB ID Card Fulfillment

Associate Leave Specialist

Unum

Jan 2020 - Jan 2022 (2 years)

Evaluated 30+ employee leave cases daily by researching FMLA, state laws, and policies to ensure eligibility and compliance, made 10+ outbound calls daily to expedite documentation, reducing return-to-work delays by 50%.

FMLA Regulatory Compliance CRM Case Management Outbound Calling

Medical Support Specialist

Unum

Jan 2019 - Jan 2020 (1 year)

Verified new FMLA claims and coordinated with providers to collect documentation, drafting 10+ daily written requests and reducing claim processing delays by 60% while improving claim accuracy.

FMLA Claims Processing Customer Support

Patient Service Representative

Erlanger Medical Center

Jan 2018 - Jan 2019 (1 year)

Performed front-desk operations using EPIC for multi-line phone support, data entry and scheduling 30+ patient appointments daily, improving intake efficiency and maintaining 100% billing accuracy.

Epic Scheduling Data Entry Insurance Verification

Customer Service Representative

Mutual of Omaha

Jan 2024 - Present (2 years 5 months)

Resolved 50+ customer inquiries daily using internal CRM to address complex account and benefit issues, achieving a 95% resolution rate and reducing repeat inquiries by 15% through improved claim-submission guidance.

Customer Service Claims Processing CRM Benefits Administration Troubleshooting

Merchandise Associate

TJX Companies

Jan 2022 - Present (4 years 5 months)

Delivered high-quality customer service across multiple store areas, supported merchandising and promoted loyalty programs while serving 50+ customers per shift to ensure strong shopping experiences.

Retail Customer Service Merchandising Point of Sale Loyalty Programs Cross Training Customer Engagement

Customer Service Representative

T-Mobile

Jan 2016 - Present (10 years 5 months)

Resolved 50+ daily customer inquiries by recommending tailored mobile plans and guiding device troubleshooting, reducing escalations by 30% and improving retention and first-call resolution.

Customer Support Troubleshooting Retention Escalation Management Call Resolution Sales