NIESHA WALLACE
Louisville,KY
Summary
Professional with strong background in customer interactions and service solutions. Highly skilled in conflict resolution, communication, and problem-solving, ensuring customer satisfaction and loyalty. Effective team collaborator, adaptable to changing needs, and consistently focused on achieving results through efficient and empathetic service. Known for reliability and proactive approach to meeting customer and organizational goals.
Overview
6
6
years of professional experience
Work History
Claims Adjuster
Evolent Health
11.2025 - Current
- Evaluate insurance claims for accuracy and compliance with company policies.
- Investigate claim details through interviews and document analysis to assess validity.
- Collaborate with healthcare providers to gather the necessary documentation for claims processing.
- Manage claim disputes by negotiating settlements and resolving conflicts effectively.
- Implement process improvements to enhance efficiency in claims handling workflows.
- Verify insurance claims and determine a fair amount for settlement.
- Maintain compliance with state regulatory requirements through meticulous documentation and adherence to company policies.
- Answer customer questions regarding deductibles.
- Evaluated insurance claims for accuracy and compliance with company policies.
- Investigated claim details through interviews and document analysis to assess validity.
Client Success Specialist
Beyond Finance - Remote
01.2025 - 04.2025
- Provided a helpful and caring customer service experience over high-volume inbound and outbound client phone calls of varying complexity by responding to client requests, anticipating unstated needs, and educating them on programs in a remote call center environment.
- Proactively identified, analyzed, and resolved client issues by utilizing active listening and critical thinking to provide first-call resolution, with a focus on the customer relationship.
- Exhibited strong written and verbal communication skills, excel at customer interaction, and deliver practical solutions.
- Worked independently and with a team to drive the retention of clients through bolstering product knowledge and providing best-in-class service at all times.
- Operated, navigated, and troubleshot a desktop computer to obtain and extract information; research through multiple computer programs and systems simultaneously, and document information, activities, and changes in the CRM database (Client Relationship Management System) for client accounts.
- Met and exceed client-centric performance expectations, focused on quality of service and efficiency.
- Managed approximately 30 incoming calls, emails and faxes per day from customers.
Technical Support Expert
Consumer Cellular - Remote
11.2023 - 09.2024
- Provided technical support to customers via phone, email, and chat, resolving inquiries on the first contact.
- Assisted customers with device setup, troubleshooting, billing and account-related issues, contributing to improved customer satisfaction scores.
- Created and maintained detailed documentation of technical issues and solutions to enhance team knowledge base.
- Collaborated with cross-functional teams to report recurring issues and improve service delivery.
Technical Support Specialist
ADT - Remote
07.2022 - 09.2023
- Assisted customers with the installation and configuration of security systems.
- Documented technical issues and solutions to help enhance the knowledge base for better team support.
- Provided technical support to customers via phone, email, and chat, and addressed inquiries related to security services, billing, and other account issues.
- Contributed to the development of customer support resources and FAQs to improve self-service options for clients.
- Resolved 30+ technical support inquiries per day.
Pharmacy Customer Service Representative
Chewy - Remote
03.2020 - 03.2022
- Prepare and dispense medications, ensuring accuracy and compliance with prescriptions.
- Communicated with patients via digital channels to provide information about medications, answer questions, and resolve issues.
- Processed prescription claims to insurers and verified patient eligibility for medications.
- Handled electronic prescriptions, managed patient records, and performed data entry tasks.
- Adhered to healthcare regulations, including HIPAA, to ensure patient confidentiality and safety.
- Assisted pharmacists in preparing and dispensing medications accurately.
- Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
Education
High School Diploma -
Southern High School
Louisville, KY06-2013
Skills
- Written & Verbal Communication
- Inbound & Outbound Calling
- Microsoft Office Suite
- Hardware & Software Troubleshooting
- Data Entry & Record Keeping
- Salesforce & Zendesk
- Windows & macOS
- Multitasking
- Typing Speed [70 WPM]
- Order Processing
- Quality Assurance
- Account Management
- Claims
Timeline
Claims Adjuster
Evolent Health
11.2025 - Current
Client Success Specialist
Beyond Finance - Remote
01.2025 - 04.2025
Technical Support Expert
Consumer Cellular - Remote
11.2023 - 09.2024
Technical Support Specialist
ADT - Remote
07.2022 - 09.2023
Pharmacy Customer Service Representative
Chewy - Remote
03.2020 - 03.2022
High School Diploma -
Southern High School