Qhama Vani

Healthcare Support Specialist with 6+ years experience in US health insurance, Medicare Advantage, and CRM platforms. HIPAA compliant, skilled in claims, prior authorizations, and de-escalation. Proven 95% CSAT and Tier 2 promotion. Seeking remote Customer Support role.

Healthcare Advocate - TTEC

(2024-03 - 2026-03)

• Processed 50+ daily member inquiries related to medical claims, EOBs, benefits, and prior authorizations for Humana Medicare Advantage members via Salesforce Service Cloud
• Reviewed claims status, denials, and AR with members/providers. Explained CPT/ICD-10 codes and coverage per CMS Guidelines
• Maintained HIPAA compliance and 100% PHI confidentiality. Documented cases within SLA
• Achieved 95% CSAT and promoted to Tier 2 for quality and accuracy in claims resolution
• Created Knowledge Base articles to reduce repeat billing inquiries and improve first-call resolution

Customer Service Advisor - Webhelp

(2020-06 - 2024-03)

Webhelp (acquired by Concentrix in 2023)

• Supported Sainsbury's accounts. Handled billing, order management, refunds, payment disputes, tech support, and retentions across 5+ CRMs
• Promoted to Tier 2 for consistent 98%+ QA. De-escalated complex P1 complaints and exceeded FCR and AHT targets monthly
• Resolved escalated customer issues via phone, email, and chat for UK and US customers
• Recognized for rapid CRM adoption with <1 week ramp time. Trained new hires on systems, processes, and customer service standards

Customer Service Associate - Amazon

(2017-12 - 2020-04)

• Resolved escalated billing, payment, account, and logistics issues for US/UK customers via phone, email, and chat
• Processed refunds, investigated payment disputes, and explained billing cycles using Amazon's internal CRM and Knowledge Base
• Maintained high productivity while supporting North America customers with accuracy and empathy