A

Ade James

About

Detail

Dhaka, Bangladesh

Timeline

work
Job

Résumé

Jobs verified_user 0% verified
  • C
    Customer Escalations Supervisor (Hybrid)
    Cambridge Health & Rehabilitation Center
    May 2022 - May 2025 (3 years 1 month)
    Oversaw high-level case escalations and client concerns across multiple departments within a long-term care facility. Coordinated with clinical staff, billing, and admin to close tickets while maintaining service integrity. Trained 12+ junior associates in proper escalation handling, documentation standards, and communication best practices. Implemented service logs to monitor response trends and identify recurring breakdowns. Reduced unresolved case volume by 23% over 6 months by streamlining response protocols. Partnered with compliance team to ensure all patient complaints aligned with HIPAA and state regulations. Awarded for building an escalation framework that improved resolution time and reduced risk.
  • U
    Medical Claims Specialist
    UBS Financial
    Jul 2019 - Apr 2022 (2 years 10 months)
    Processed and audited high-volume claims, ensuring proper documentation and code accuracy across medical plans. Investigated discrepancies between provider-submitted claims and benefit policies. Improved batch processing by 18% through automation and system tagging enhancements. Created a live tracker used by the claims team to track real-time case movement and pending flags. Delivered weekly compliance checks and documentation audits across assigned accounts. Contributed to redesign of digital claim forms to reduce user error during submission. Increased claim closure rates by 21% in Q4 2021 by integrating smart batch routines. Designed an internal claims training module that became the standard for onboarding new team members.
  • Meijer
    Member Service Representative
    Meijer
    Jan 2017 - Jun 2019 (2 years 6 months)
    Supported member inquiries regarding discounts, returns, and service adjustments both in-store and online. Managed loyalty account issues, transaction reversals, and refund workflows. Updated CRM entries daily, tagging all touchpoints for improved traceability. Assisted with fraud report filings related to stolen loyalty credentials. Coordinated with internal audit teams for inventory mismatch reporting. Boosted member satisfaction scores by 14% by simplifying loyalty program support steps.
  • A
    Technical Support Representative
    Aetna Healthcare Services
    Jan 2015 - Dec 2016 (2 years)
    Delivered Tier-1 tech support to patients and clinicians navigating insurance portals and health tracking systems. Logged, tracked, and resolved high-volume service tickets while maintaining HIPAA compliance. Supported software updates, password resets, and multi-device integrations. Partnered with product teams to report recurring issues, cutting duplicate tickets by 18%. Increased first-call resolution by 12% and reduced repeat inquiries by 9% through guided walkthroughs. Led internal pilot testing on a new mobile claims app for usability feedback.
Education verified_user 0% verified
  • Middlesex University
    B.Sc.
    Middlesex University
  • H
    Healthcare IT Specialist Customer Service Excellence Salesforce Certified User Technical Support Professional