Agile and adaptable leader and advocate with stellar customer service, work ethic, motivational approach and upbeat nature. Skilled at training employees and leveraging organized approaches to handle daily planning, scheduling and customer service requirements. Top performer every quarter. Forward-thinking and industrious with diplomatic communication style focused on maximizing engagement and satisfaction. Proficient in health benefit enrollment and council.
Skills
Teamwork
Coaching / Mentoring
Detail-oriented
Customer support
Documentation and reporting
Quality Assurance Controls
Professional Telephone Voice
Account management
Calm disposition
Problem-solving skills
Verbal and written communication
Microsoft Office / Google Suite
Complaint resolution
Call center operations
Logging call information
Work History
Quality Assurance Lead, eni, 11/2019 to Current Rochester General Health System – Norfolk, NY,
Drive a culture of customer focus, continuous improvement, and personal excellence
Maintain and interpret quality guidelines and standards
Document activities and internal reporting and utilization
Perform call monitoring and provide trend data utilizing the data management system
Monitor omnichannel customer contacts
Compile calls, texts, chats, and case metrics for quality standards and training purposes
Monitor calls, texts, chats, and case metrics quality to provide individual constructive feedback to enhance performance and address areas in need of improvement
Review and analyze calls, metrics, and KPI regularly with agents on a set schedule
Identify training needs and provide coaching and feedback to agents and leadership
Continuous quality improvement for processes and procedures
Establish and oversee performance targets for call center associates
Train team members on performance metrics
Effectively manage assigned cases, collecting and documenting details as needed using proprietary software
Sr. Benefits Specialist, Sr. Professional Health Advocate, 08/2018 to Current Orbital Engineering, Inc. – Saint Louis, MO,
Answer incoming calls, emails, texts and chats in a fast-paced, high-volume call center environment
Successful utilization of CRM and call center applications
Deliver services according to established advocacy and case management protocols and maintain accurate, legible and current documentation
Enroll clients into benefits and provide benefit education
Maintain HIPPA Compliance
Serve as the client voice in the benefits and employee assistance program realm
Manage two large accounts for major companies monitoring satisfaction, utilization, and escalations
Answer questions related to bills received by patients and work with insurance companies and providers
Successfully navigate struggling clients and customers with complaints and complex concerns providing timely follow-up
Triage claims, authorizations, and denial issues and write appeals for members
Interact with insurance carriers and providers to negotiate favorable outcomes for employees
3.7M dollars of cost avoidance for members
Point of contact for benefit inquiries such as claim issues, plan changes, benefits enrollments, status changes, leave of absence requests and other general inquiries
Work with internal and external parties to resolve customer issues and improve the customer experience
Serve on project teams to improve customer delivery, product, and efficiency
Peer Educator, 01/2017 to 02/2018 CRMC – City, STATE,
Conducted outreach and education activities to over 2000 people
Presented breast and prostate cancer information to the target population
Assisted with the design and distribution of educational and marketing materials for events
Registered clients and verified client information
Arranged medical appointments, transportation, and referral services for clients
Provided follow-up and customer services to ensure client satisfaction
Field Inspector, 02/2015 to 12/2016 Empire Field Services LLC – City, STATE,
Provided visual inspections for financial institutions 100% remotely
Verified addresses and occupancy information
Confirmed occupancy on foreclosed properties
Made contact attempts and left callback notices
Performed exterior and interior inspections
Took photos and wrote inspection reports
Used proprietary software to upload photos and reports to financial institutions.
Education
No Degree: Humanities, Expected in California State University At Dominguez Hills - Graduate Studies, GPA:
Bachelor of Science: Music Education, Expected in State University of New York – Crane School of Music - Potsdam, NY GPA:
Associate of Arts: Liberal Arts, Expected in State University of New York – Broome Community College - Binghamton, NY GPA:
Additional Information
LICENSES: NYS Life and/or Accident/Health Agent License# 1543910,
AWARDS: eni Employee of the Quarter for exemplifying the company’s Core Values
Resumes, and other information uploaded or provided by the user, are considered User Content governed by our Terms & Conditions. As such, it is not owned by us, and it is the user who retains ownership over such content.
How this resume score could be improved?
Many factors go into creating a strong resume. Here are a few tweaks that could improve the score of this resume:
resume Strength
Length
Personalization
Strong Summary
Target Job
Typos
Resume Overview
School Attended
California State University At Dominguez Hills
State University of New York – Crane School of Music
State University of New York – Broome Community College
Job Titles Held:
Quality Assurance Lead, eni
Sr. Benefits Specialist, Sr. Professional Health Advocate
