Alexis Grinie

• Assist members once they request a Supervisor
• Provide members with accurate and appropriate information to answer questions, troubleshoot issues, and resolve member complaints.
• Focus on proficiency following Medicare guidelines.
• Maintain patient confidentiality and function within the guidelines of HIPAA.
• Document all call information according to standard operating procedures
• Review all required documentation to ensure accuracy
• Complete insurance verification to determine patient's eligibility, coverage, co-insurances, and deductibles
• Pays attention to detail and has great organizational skills
• Actively listens to patients and handle stressful situations with compassion and empathy
• Builds and maintains Medicare Advantage knowledge and skills. Participates in refresher or other training as needed.
• Conducts research and takes appropriate action on customer inquiries specific to determined channel(s). Recognizes and takes action to address issues that may impact other customers. (Strives for resolution on first contact).
• Communicates information/solutions clearly, accurately, and effectively in a manner that provides peace of mind to the customer
• Intakes, acknowledges, prepares case files and routes complaints to appropriate internal department for investigation and resolution, exercising strong independent judgment.
• Maintain quality and productivity standards as set by management

• Utilizes complaint documentation standards
• Providing empathy and advocating for members
• Ensure that every member is shown with respect, Kindness and all questions are thoroughly answered/resolved.
• Provide Durable Medical Equipment Provider to members
• Provide In Network Providers (PCP, Specialist and ETC.) to members
• Inform them of what their Deductible is for the year and what claims have been applied to their Deductible
• Inform the member on how the Deductible, Out of Pocket Expense and Copays work
• Answer any questions they have regarding copays for certain procedures and what is required for those procedures to be covered
• Go over claims with members in regards to copays or deductible
• Send claims up for rework when needed
• File Grievance and Complaints when member seems distraught about an experience with a provider
• Assist with Supervisor Escalation Calls when needed
• Assist with special projections when needed
• Listen to my own and other recorded calls to see where improvement can be made
• Provide Pre-Auth details
• Reach out to Providers to resolve issues in regards to billing
• Assist with escalations callback/emails
• Pull calls and review for escalation and possible coaching
• Shadow CSRs and inform them where improvements can be made
• Huddle Champion / Leads huddle occasionally for supervisor
• Live listen CSRs
• Review calls for call avoidance
• Provide assistance to agents when needed
• SME for Team Chats
• Chat Mentor to my team and other supervisor teams
• Direct agents to resources they can use with their day-to-day work
• Create helpful and resourceful workflows for developing purposes
• Leads SONJ Workbasket
• Manage updates on behalf of the SONJ Workbasket
• Follow up about having checks reissued
• Train new hires on how to handle the SONJ Workbasket
• Calculate monthly trends for ACE markdowns
• Go over ACE scores and as to how the grades were determined
• Go over how we can improve our team ACE scores for my teams and other supervisor teams
• Review disputed ACE calls
• Go over how to improve metrics
• Assist representatives when they come back from LOA
• Assist other supervisor with their Team Chat
• Attend and assist interviews with my supervisor and other supervisors
• Provide coaching to CSRs

• Answer all incoming calls and direct or take messages as necessary
• Assisting with copying, scanning, faxing, and emailing
• Manage employees
• Collect all information needed to calculate bills receivable (order amount, company percentage etc.)
• Check the data input in the accounting system to ensure accuracy of the final bill
• Preparing and organizing work schedules for employees to make sure that the required/appropriate number of staff are on duty in every given work period/shift
• Schedules and approves work-leave for employees as well as making sure vacant posts are filled to meet staffing requirements for the company
• Assist the company with recruiting potential candidates for employment.
• Monitor and manage inventory of business supplies; order supplies as necessary.
• Maintains inventory room organization.
• Assign work orders to employees as the day goes by. That includes any form of maintenance needing to be completed for the units. It also includes sending employees out to clean the grounds and inspect the house to make sure they are up to our standards for the guest
• Direct guest call inquiries to the appropriate employee
• Close/Approve work order after confirming the employee grammar is correct for the owners notations and after confirming the billing has been completed
• Order parts as needed for the units or the company.

• Answer all incoming calls and direct or take messages as necessary
• Directing internal and external calls, emails, and faxes to designated estimators
• Assisting with copying, scanning, faxing, and emailing
• Ensure that all documents are accounted for during the process of repairing a vehicle and file the completed file
• Greet customers in a timely and friendly manner
• Schedule appointments using dealership-approved forms
• Prepare all vendor invoices and assign purchase order numbers as necessary
• Obtain customer and vehicle data as needed for collision center estimators
• Establish each customer's method of payment
• Maintain Customer Satisfaction Index rating comparable to that of the manufacturer or dealership average
• Obtain customer's signature on repair orders or final bills; provide customer with a copy
• Receiving invoices and matching them up with the unpaid insurance invoices before turning them in for payment
• Process insurance checks once received in the mail
• Distribute the mail daily
• Filing documents, as well as entering data
• Post all funds received from the repairs of a vehicle to the appropriate repair order
• Call customer when vehicle is ready and schedule the appointment for the vehicle to be picked up
• Prepare funds for the deposit by making copies of the invoices paid as well as the checks and currency received as payment for the repairs
• Monitoring coffee supplies and water; ordering replacements
• Confirm Deposits are accounted for and correct at the end of the day. Then send them to accounting
• Enter part sublets/invoices when needed
• Confirm parts that were ordered and received are enter into the system correctly
• Keep track of tow ins and assign to estimators
• Reach out to customer regarding their estimate to see if they are ready to schedule to drop off for repairs
• Billing the correct dealership for internal tickets and then proceed closing them.

Call Center Representative

• Providing customer support in high volume call center for Roadside Assistance
• Ask callers open ended questions to gather as much information as possible to ensure the correct tech was sent out
• Processed phone payments for services not covered in original roadside assistance contract
• Follow up with the caller to ensure that everything was completed correctly and in a timely manner
• Resolve customer complaints in a timely and empathetic manner
• Roadside Assistance provided for the following companies Progressive, Amica, Nationwide, Ford Mercury, Hyundai, Chrysler, Toyota, Honda, Erie

Escalated Call Team I

• Handle Escalated calls for Liberty Mutual, Safeco and Progressive Roadside Assistance Programs
• Over seek call center representatives taking calls and step in when de-escalation is needed
• Speak with an upset customer and try to deescalate the situation so calls don't need to go to level II
• Ask callers open ended questions to gather as much information as possible to understand why they were not satisfied with service
• Resolve customer complaints in a timely and empathetic manner

Cashier

• Count till before and after shift
• Greeted customers, offered to call for customer assistance when needed, directed customer on how to find products they are looking for
• Helped customer to finalize purchases by processing payments viz check, credit / debit card and cash
• Send large amounts of money to the vault for safe keeping
• Requested change to insure till had enough small bills to give change to customers

Service Desk

• Count till before and after shift
• Greeted customers, offered to call for customer assistance when needed, directed customer on how to find products they are looking for
• Answer inbound store calls and transfer them to the correct departments
• Process Will Call sales for customers to pay for items now and pick up later
• Process special orders for items not sold in store
• Process phone sales for customers that send contractors into the store for items
• Contact special order vendor to ensure orders have been received and are processing
• Have orders pulled and staged for customer pickup
• Call customers to inform them that special order or will calls are ready for pick up

Inventory Management Team

• Confirm on hand counts of store product
• Pack out product and front face product
• Create inventory labels after confirming accurate count
• Stage items in the overheads