Ane Marcellus
Miami,FL
Summary
Dynamic professional with extensive experience at Optum Insight, specializing in quality assurance and customer service. Demonstrated success in employee training and cross-functional collaboration, leading to improved operational efficiency. Expertise in attention to detail and effective communication, consistently meeting program-specific goals and enhancing team performance.
Overview
17
17
years of professional experience
Work History
Sr. Business Operations Coordinator
Optum Insight
Remote, Florida
05.2024 - Current
- Confirmed health plan members' coverage with employers and other health plans over designated periods.
- Contacted providers to obtain medical records for completed procedures from prior year for review.
- Collaborated with third-party vendors to facilitate efficient retrieval of necessary records.
Sr. Quality Assurance Specialist
Change Healthcare/Optum Insight
Remote, Florida
09.2020 - 05.2024
- Monitored quality assurance procedures to ensure employee compliance, addressing non-compliance issues promptly.
- Conducted over 100 evaluations monthly, delivering written and verbal feedback for coaching and development.
- Employed root cause analysis techniques to identify and resolve quality-related issues.
- Prepared comprehensive reports detailing results of quality inspections for management review.
- Maintained rigorous quality assurance protocols, processes, and procedures.
- Collaborated with cross-functional teams to uphold quality objectives throughout the organization.
- Trained cross-functional teams on new scripting techniques to meet established goals.
Eligibility Counselor/Advocate Member Service Representative
Change Healthcare
Weston, FL
06.2016 - 09.2019
- Facilitated health plan members' prescreening for Medicare Savings Program and local assistance programs.
- Assisted members with annual renewal for reimbursed Part B Premium eligibility.
- Monitored key performance indicators to achieve quality and program-specific goals on daily, weekly, and monthly basis.
Case Manager
Global Response Corporation
Margate, US
12.2015 - 04.2016
- Inbound- customer service with account information, concerns and issues, created cases for all incoming calls, resolved customer matters
- Outbound- made calls to escalated cases to close the case or resubmit for further investigation
- Monitored and investigated web errors on zara.com for U.S., Canada and Mexico on a daily basis to ensure prices, apparel and models were displayed accurately for the customers
- Phone system- Cisco
Guest Service Team Leader/Customer Service
Target Corporation
Miami, US
01.2008 - 10.2014
- Supervised front lanes, managing 36 cashiers and additional team members to enhance service efficiency.
- Ensured comprehensive training for team members to improve customer service experiences.
- Coached staff on training needs instead of discipline to promote professional development.
- Created daily and weekly schedules, including breaks and lunches, for optimal team performance.
- Trained team members on cash office operations to ensure accurate financial handling.
- Provided change and balanced cash drawers for each active register at day's end.
- Supported sales representatives in initiating new credit card accounts to boost revenue.
- Resolved customer challenges swiftly and effectively to enhance satisfaction.
Education
Business -
University of Phoenix
Miramar, FLSkills
- Customer service and support
- Quality assurance
- Cross-functional collaboration
- Employee training and development
- Team leadership
- Effective communication
- Attention to detail
- Teamwork
Personal Information
- Total Experience: More than 20 years of successful experience in customer service and customer support with recognized strengths in supervising team members, problem-solving overall guests experience and overseeing that all transactions go well for every cashier and customers are satisfied.
- Authorized To Work: US
Languages
English
Professional
Haitian Creole
Native/ Bilingual
Timeline
Sr. Business Operations Coordinator
Optum Insight
05.2024 - Current
Sr. Quality Assurance Specialist
Change Healthcare/Optum Insight
09.2020 - 05.2024
Eligibility Counselor/Advocate Member Service Representative
Change Healthcare
06.2016 - 09.2019
Case Manager
Global Response Corporation
12.2015 - 04.2016
Guest Service Team Leader/Customer Service
Target Corporation
01.2008 - 10.2014
Business -
University of Phoenix
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