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supervisor resolutions pc ii team lead program coordinator resume example with 11 years of experience

Jessica Claire
, , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
Home: (555) 432-1000 - Cell: - resumesample@example.com - : - -
Summary

I am passionate about all things Client Relations. I have an extensive background servicing clients in Healthcare, Media, and Business-to-Business environments. I'm a dedicated liaison that employs analytical thinking and thorough research to deliver solutions that streamline work processes. I pride myself on being a problem solver in a wide variety of situations who can deliver reasonable and effective outcomes under tight deadlines. I use creative and innovative methods that have garnered outstanding reviews from patients, customers, peers, and managers.

Skills
  • Customer/Client Service Expert for 25+ years
  • Energetic Work Attitude
  • Supervisor / Team Lead Experience
  • Active Listening
  • Critical Thinking
  • Goal-oriented
  • Issue and conflict resolution
  • Deadline-driven
  • Multitasking
  • Reliable and trustworthy
  • Voiceover Artist (Commerical and Technical)
  • Microsoft Office (Advanced user of Word, Excel, PowerPoint)
  • Apple iWork (Pages, Numbers, KeyNote)
  • Audio & Video Editing (Sony Vegas Pro, Adobe Creative Suite, Apple GarageBand, Apple iMovie)
  • Flow Process Diagrams
  • Data Anaylitics and Reporting
Experience
10/2017 to Current
Supervisor-Resolutions/PC II-Team Lead/Program Coordinator Hopehealth West Greenwich, RI,
  • Full-time employee at PA Health & Wellness with progressive experience and recognition for assisting members in multiple roles.
  • First six months were as an employee of Kelly Services
  • Key Skills: Supervisor, Problem Resolution, Customer Service, Metric Tracking, Mentoring and Coaching, Process Development, Team and Program Development, Liaison between Participant, Providers, Contractors and Clients, Workflow Management, Analytical Thinking, Technical Writing, Business Systems Analysis, Training, Transportation Logistics

SUPERVISOR (September 2019 to Present)

  • Responsible for leading a team of 25 Program Coordinators in resolving concerns and questions presented by Participants and Providers concerning LTSS and Medicaid benefits for a Managed Care Organization working with Pennsylvania's Community Health Choices program.
  • Apply strong leadership talents and problem-solving skills to maintain team efficiency.
  • Supervisor of Transportation team charged with finding rides offering solutions for Participants requiring expedited medical appointments, develops relationships with transportation providers.
  • Responsible for organizing team workflows to meet daily demand of incoming phone calls.
  • Consistently measure and report on the team's performance and metrics to leadership. This has led to an increase of team's Adherence by 10% in the span of six months.
  • Conduct and schedule evaluations to assess work performance.
  • Facilitate inbound, escalated phone calls for both Participants and Providers regarding medical benefits, co-pays, and claims inquiries.
  • Responsible for staffing, performance management and reviews, including coaching, mentoring, salary development, and budget allocations.
  • Analyze and coach team on data regarding Average Handle Times, Abandoned Call rates, and Adherence, and Call Scoring.
  • Coach staff to eliminate errors on Call Reviews leading to an improvement of 15% in Customer Survey ratings.ssist in planning and executing of quarterly Participant Advisory committee meetings designed to gauge reactions and feedback from Participants. These meetings have helped streamline in-house procedures, lowered outbound costs, and provided better outcomes for Participants.

PROGRAM COORDINATOR II / TEAM LEAD (September 2018 to September 2019)

  • Developed, executed, and supervised a "Nesting" program following in-house training, combining real work situations along with continuing education that built success for new Program Coordinators.
  • Managed and used problem solving skills under tight deadlines to find solutions for issues presented by Pennsylvania's Office of Long-term Living.
  • Identified and troubleshooted areas with Transportation and found solutions in areas such as scheduling rides along with assessing the needs of Participants and Providers.
  • Developed procedures to streamline Transportation procedures at PA Health & Wellness that included developing procedures for scheduling trips, education of procedures for Program Coordinators and Service Coordinators, and filing reports with the state of Pennsylvania. This has resulted in saving money for providers and the health plan in the first two years with the plan.
  • Coached Program Coordinators with reviews of recorded calls on proper handling techniques, etiquette, and required information.
  • Contributed to team meetings and educational sessions for Program Coordinators on a wide variety of topics as part of an ongoing education curriculum.
  • Consistently scored at a level of 98% or higher in telephone quality metrics along with maintaining optimal call handling times of 15 minutes or less under guidelines set by Centene Corporate and Pennsylvania's Office of Long-Term Living.

PROGRAM COORDINATOR (September 2017 to September 2018)

  • Provided assistance to Participants and Providers via inbound calls with timely responses. Assisted with solutions and information in response to their healthcare.
  • Developed a program used by Program Coordinators to track and report inbound calls sent to After Hours Voice Mail received in off-hours.
  • Established Transportation team that identified and troubleshooted areas in scheduling rides for Participants with contracted transportation provider. Developed procedures that streamlined problems with missed and late trips by 80%.
  • Developed programs and worked with upper management that researched and reported on issues presented by Pennsylvania's Department of Long-Term Living involving complaints from Participants and Providers. Most issues were resolved within 2 business days of first notification.
12/2015 to 09/2017
Patient Care Coordinator Munson Medical Center Cadillac, MI,
  • Key Skills: Customer Service, Problem Resolution, Deadline Driven, Coordination of Patient Care, Process Development
  • Planned, integrated and maintained quality care systems and standards, which resulted in creating and improving medical protocols and guidelines.
  • Submitted various medication requests electronically.
  • Communicated with patients to ensure quality of care and develop care plans.
  • Addressed over 60 pharmaceutical orders via fax, mail, telephone, and/or through patient direct contact, converting approximately half into completed orders on a daily basis.
  • Provided timely responses to patients' inquiries by telephone, consistent with service and quality standards that prevented delays in the delivery of medications for patients.
  • Coordinated patient care by scheduling orders, communication information to the patient regarding shipments, assessing patient needs, verifying patient and payment information, notifying pharmacists of issues or changes in the patient's condition.
  • Developed a streamlined system for transcribing patients notes regarding delivery and co-pay information that was utilized by management for training purposes.
  • Maintained up-to-date knowledge of policies regarding new medications and trends in pharmaceutics. Ensured that good relations with patients are maintained and that their complaints and claims are resolved fairly and effectively.
  • Coordinated and planned work-place functions for employees that recognized company-wide achievements.
05/2012 to 12/2015
Contract Roles With a Customer Centric Focus AppleOne, Kelly Services City, STATE,

Contract Roles with a Customer-Centric Focus - AppleOne and Kelly Services - Pittsburgh, PA - (May 2012 - December 2015)

MORTGAGE TITLE ASSISTANT, Fidelity National Financial - Pittsburgh, PA

  • Key Skills: Deadline Driven, Budget Management, Resolution Management, Process Development, Training
  • Temporary Assignment through AppleOne
  • Managed and processed approximately 20 orders on residential titles on a daily basis required by mortgage lenders and realtors in order to facilitate the closing of the mortgage process in a timely manner.
  • Placed nearly 40 orders daily with title examiners to search properties for updated liens, defaults, and outstanding loans.
  • Processed and updated property information required by mortgage lenders.
  • Managed a budget valued at nearly $2,500 on a weekly basis for third party searchers for services provided to the company.

PRIOR AUTHORIZATION REPRESENTATIVE, Accredo Health Group - Warrendale, PA

  • Responsible for efficient resolution of member and client related issues.
  • Verified medical and insurance information for over 150 patients weekly order to help expedite the shipping process of vital, life-saving medicines and therapies for patients.
  • Provided direction and support for team members, supervisors, and patients.
  • Resolved concerns and answered questions for patients in a timely manner to help alleviate problems with shipments of medical supplies.
  • Responsible for screening and disseminating crucial information required to provide necessary coverage for patient care.

ACCOUNTING COORDINATOR, Align Networks - Canonsburg, PA

  • Processed accounts receivables and payables (valued at over $100,000/week) received/paid from various insurance carriers for patients' workers compensation claims.
  • Generated Excel spreadsheet reports reflecting detailed transactions for claims.
  • Secured payment verification from insurance companies and ensured timeliness of incoming payments.
  • Interfaced closely with claims adjusters from major insurance companies such as Liberty Mutual and Concentra.

CUSTOMER SERVICE REPRESENTATIVE. FedEx Ground - Moon Township, PA

  • Generated detailed daily reports on reported freight reflecting type/value/quantity of cargo sent with values up to $60,000 per shipment.
  • Resolved all customer issues relevant to customs, late shipments, and incorrect data.
  • Played a key role in saving a multi-million dollar FedEx customer significant financial resources.
  • Streamline process on invoices for international shipments by creating internal procedural forms, a concept which was subsequently adopted as protocol.
  • Eliminated delivery issues, increased high-volume shipment efficiency, and enabled the ability to secure “real time” shipment information to customers by testing/proving the effectiveness of the company's new in-house online data processing systems.
  • Chosen out of company peers to train all CSRs on the company's computer/data entry system, telephone etiquette, and procedural protocols for charting/servicing customer service complaints.
10/2009 to 09/2011
Admissions Representative The Art Institute Of Pittsburgh City, STATE,

ADMISSIONS REPRESENTATIVE - The Art Institute of Pittsburgh - Pittsburgh, PA - (October 2009 - September 2011)

  • Key Skills: Focus on Student Success, Multi-Tasking, Financial Aid Education, Liaison between Students and Institute
  • Developed and implemented a marketing plan to attract students into school programs which ensued in new enrollment of more than 150 students.
  • Conducted student interviews with focus defining the education programs, admissions process, on-line studies, expected outcomes, and student services. Assisted with financial aid applications and on-line course procedures.
  • Worked with college administrators in processing and securing transfer credits.
  • Succeeded in ensuring that enrollment goal plans produced targeted student recruitment results consistent with the Admissions Department's goals.
Education and Training
Expected in to to
Bachelor of Science: Communication/Computer Information Science
Clarion University of Pennsylvania - Clarion, PA
GPA:

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Resume Overview

School Attended

  • Clarion University of Pennsylvania

Job Titles Held:

  • Supervisor-Resolutions/PC II-Team Lead/Program Coordinator
  • Patient Care Coordinator
  • Contract Roles With a Customer Centric Focus
  • Admissions Representative

Degrees

  • Bachelor of Science

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