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Customer Service Quality Specialist Resume Example

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CUSTOMER SERVICE QUALITY SPECIALIST
Professional Summary

Knowledgeable and dedicated health administration professional with extensive experience in the healthcare industry. Solid team player with an outgoing, positive demeanor and proven skills in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality, speed, and process optimization. Articulate, energetic, and results-oriented with exemplary passion for developing relationships, cultivating partnerships, and growing businesses.

Work History
Customer Service Quality Specialist,09/2016 - CurrentCompany Name, City, State
  • Problem solves and utilizes critical thinking skills to come up with innovative long-term solutions.
  • Prepare detailed reports on updates to project specifications, progress, identified conflicts and team activities.
  • Communicates with leadership and staff when concerns are identified.
  • Partner and collaborate with operations staff to ensure that benefits and programs are administered per regulatory, statutory, and plan-specific guidelines.
  • Inspire, motivate, and guide others toward accomplishing goals and achieving desired results through effective team building.
  • Maintain satisfaction with forward-thinking strategies focused on addressing agent needs and resolving concerns.
  • Perform qualitative analysis of records to ensure accuracy, internal consistency, and correlation of recorded data.
  • Establish efficient workflow processes, monitored daily productivity, and implemented modifications to improve personnel and activities' overall effectiveness.
  • Complete ad hoc projects and reports for internal statistical needs as requested.
  • Track employee performance; Analyze call center statistics to ensure optimal performance.
  • Provide customer support to internal and external customers in a fast-paced environment.
  • Prepare detailed documents and reports in adherence to administrative processes.
  • Address questions and manage communications with members and insurance agents.
  • Transcribe meeting minutes for Management's records.
  • Produce high-quality documents, spreadsheets, and presentations for internal and customer-facing needs using MS Office Suite.
  • Interpret management directives to define and document administrative staff processes.
  • Develop internal requirements which complied with quality standards to minimize regulatory risks and liability across the department.
  • Keep digital records organized for easy updating and retrieval by authorized team members.
  • Prepared daily statistical reports to assist business leaders with crucial decision-making and strategic, operational planning.
  • Help employees with day-to-day work and complex problems by applying motivational and analytical strategies.
Lead Customer Service Representative,04/2015 - 09/2016Company Name, City, State
  • Strong leader of customer support staff.
  • Train staff on operating procedures and company services.
  • Investigate and resolve customer inquiries and complaints in an empathetic manner.
  • Met all customer call guidelines including service levels, handle time and productivity.
  • Identify individual development needs with appropriate training.
  • Follow-through on critical inter-departmental escalations to increase customer satisfaction.
  • Effective liaison between customers, representatives and internal departments.
  • Delivered world-class customer service.
  • Planned schedules and workflows based on expected customer demands.
  • Executed regular process updates to reduce discrepancies and enhance communication
Customer Service Representative,02/2014 - 04/2015Company Name, City, State
  • Politely assist customers in person and over the telephone.
  • Answered health insurance benefit questions with up-to-date knowledge.
  • Managed customer calls effectively and efficiently in a complex, fast-paced and challenging call center environment.
  • Act professionally and patiently when addressing negative customer feedback.
  • Met or exceeded service and quality standards every review period.
  • Mastery of customer service management systems and databases.
  • Referred unresolved customer questions and concerns to appropriate department for further investigation Accurately documented, researched and resolved customer questions.
  • Documented and detailed calls and complaints using call center's Facets database.
Lead Medical Office Specialist,09/2008 - 02/2014Company Name, City, State
  • Scheduled appointments, registered patients and professionally and courteously verified appointment times with patients.
  • Adeptly managed a multi-line phone system and pleasantly greeted all patients.
  • Prepared patient paperwork and consent forms as necessary.
  • Determined if prior authorizations were needed for outpatient procedures.
  • Meticulously identified and rectified inconsistencies, deficiencies and discrepancies within the department.
  • Examined patients\\' insurance coverage, deductibles, possible insurance carrier payments and when applicable.
  • Researched questions and concerns from providers, patients and provided detailed responses.
  • Treated all patients, their families, visitors, peers, staff and providers in a pleasant and courteous manner.
Skills
  • Team leader
  • Problem solver
  • Detail oriented
  • Communication
  • Insurance benefit comprehension
  • Research and data analysis
  • Report preparation
  • Resourceful and reliable
  • Planning and development
  • Analytical thinker
  • Forward-thinker
  • Excellent work ethic
  • Self-motivated professional
  • Flexible & Adaptable
Education
Bachelor of Science, Health Administration
Purdue University Global -City
Bachelor of Science, Health Administration and Management,2020
Colorado State University -City, State
2008
Linn Benton Community College -City, State
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Resume Overview

School Attended

  • Purdue University Global
  • Colorado State University
  • Linn Benton Community College

Job Titles Held:

  • Customer Service Quality Specialist
  • Lead Customer Service Representative
  • Customer Service Representative
  • Lead Medical Office Specialist

Degrees

  • Bachelor of Science , Health Administration
    Bachelor of Science , Health Administration and Management 2020
    2008

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