Ashley McCoy
Sugar Land,TX
Summary
Friendly and analytical Senior Call Center Representative with 15 plus years of experience handling technical and non-technical customer calls in large and small call center environments. Able to consistently exceed KPIs by using custom and pre-defined call scripts. Excellent interpersonal skills and a trained expert in conflict management. Skilled Appeals Representative with significant experience in healthcare claims and appeals processing. Possess strong knowledge of regulatory standards, policy interpretation, and claim dispute resolution. Known for exceptional problem-solving capabilities, negotiation skills, and ability to achieve beneficial outcomes. Previous roles involved demonstrating consistent efficiency in handling high-volume caseloads while maintaining quality standards.
Overview
12
12
years of professional experience
Work History
Customer Service Representative
UnitedHealth Group
Sugarland, TX
02.2018 - Current
- Handle 50 or more inbound calls per week, answering customer inquiries and resolving issues
- Greet all customers with a warm, friendly welcome
- Follow up on customer inquiries quickly and efficiently
- Answer basic questions from customers in a clear, friendly manner
- Document and quickly resolve all customer satisfaction issues
- Met monthly goals for consecutive months.
- Apply organization and time management skills when coordinating and responding to inbound telephone and email inquiries.
- Research and stay abreast of current insurance regulations to proactively inform clients of policy and fee updates.
- Educate new clients on policy options
- Maintained an accurate account of client information and enrolled policies in database
- Processed medical claims for providers and members
- Created cases for appeals.
- Submitted appeals on behalf of members and providers
Customer Service Representative/Call Center
Sutherland Global Call Center (VA HEALTHCARE)
Houston, Texas
11.2015 - 01.2018
- Perform opening and closing duties
- Greet all customers with a warm, friendly welcome
- Follow up on customer inquiries quickly and efficiently
- Maintain safe, fun working environment
- Answer basic questions from customers in a clear, friendly manner
- Respond to all inquiries and requests in a timely manner
- Register new patients and update information for current patients
- Manage busy, multi-line phone system
- Liaise between patients and insurance company
- Collect payments and fees according to office protocols
- Confirm accuracy of patient history
Customer Service Representative/Call Center
HARRIS COUNTY TOLL AUTHORITY
Houston, TX
03.2013 - 07.2015
- Respond to customer inquiries quickly via phone, email, or in-person
- Proposed relocating deposit/withdrawal slip station to convenient, visible location, decreasing client wait time at teller line by average of 3 minutes and increasing workflow efficiencies
- Greet all customers with a warm, friendly welcome
- Perform opening and closing duties
- Created 20 and more customer service email scripts used across the company to interact with customers
- Train many new hires, ensuring compliance with all regulations and standards
- Answer basic questions from customers in a clear, friendly manner
- Collect payments and handle petty cash
- Organize all operations, focusing on quality and consistency
- Answered an average of 50 and more calls per day from unsatisfied customers related to delays in shipment, order mistakes, and lost orders
- Document and quickly resolve all customer satisfaction issues
Health Care Specialist
COMMUNITY HEALTH CHOICE
Houston, TX
09.2012 - 02.2013
- Proposed more efficient call script to reduce average customer handling time, which was well-received and implemented by management
- Made 20 outbound calls per day to follow up with customers who were overdue in their payments
- Update workflow spreadsheet regularly
- Update case files to consistently maintain accurate records
- Document information discussed at daily meetings
- Develop comprehensive care plans and revise as needed
- Scheduled home visits and schedule follow-up appointments
Education
Diploma -
Kempner High School
sugarland, tx05.2004
Associate of Applied Business - human resources administration management
Houston Community College
houston, txSkills
- Customer service
- Call center
- Microsoft Word
- Excel
- Data entry
- Billing and Coding
- Epic
- Complaint resolution
- Inbound and Outbound Calling
- Medical terminology knowledge
- Claims Investigation
- Grievance management
Timeline
Customer Service Representative
UnitedHealth Group
02.2018 - Current
Customer Service Representative/Call Center
Sutherland Global Call Center (VA HEALTHCARE)
11.2015 - 01.2018
Customer Service Representative/Call Center
HARRIS COUNTY TOLL AUTHORITY
03.2013 - 07.2015
Health Care Specialist
COMMUNITY HEALTH CHOICE
09.2012 - 02.2013
Diploma -
Kempner High School
Associate of Applied Business - human resources administration management
Houston Community College