Carol Littles
Jacksonville,US
Summary
Dedicated customer service professional with over 12 years of experience in high-volume call centers, client support, and issue resolution. Skilled in handling inbound and outbound calls with empathy, active listening, and professionalism. Adept at navigating multiple systems, documenting interactions in CRMs, and resolving client concerns on the first contact. Recognized for adaptability, strong communication, and a solution-oriented mindset.
Overview
12
12
years of professional experience
Work History
ANALYST II, QUALITY-PROCESS AUDITS
Florida Blue - Blue Cross Blue Shield of Florida
Jacksonville, USA
06.2024 - Current
- Conducted regular audits of customer interactions to maintain service excellence.
- Monitor systems for accuracy and compliance, ensuring optimal performance and reliability.
- Reviewed agent performance and provided constructive feedback for improvement.
- Analyzed call recordings using quality monitoring systems for insights.
- Collaborated with team leaders to address performance issues effectively.
- Developed training materials based on common agent challenges identified in calls.
- Facilitated workshops such as call calibrations to enhance skills and knowledge among call center staff.
- Reported findings to management, highlighting trends and areas for development.
ISSUE MANAGEMENT SPECIALIST
Florida Blue - Blue Cross Blue Shield of Florida
Jacksonville, USA
09.2023 - 06.2024
- Collaborated with internal/external sales teams to resolve complex issues, enhancing cross-departmental efficiency.
- Identified delay trends and improved processes, boosting operational performance.
- Educated sales teams on products and compliance, increasing service accuracy.
- Utilized Microsoft Office for effective communication and data management.
- Supported sales team members to drive growth and development.
AGENCY ENGAGEMENT SPECIALIST
Florida Blue - Blue Cross Blue Shield of Florida
Jacksonville, USA
01.2022 - 09.2023
- Resolve agent and inquiries on claims, benefits, and enrollment, enhancing satisfaction.
- Identify and remove enrollment barriers, boosting customer retention and agent satisfaction.
- Deliver essential process and system documentation, ensuring compliance and efficiency.
SERVICE ADVOCATE IV - DEDICATED WRITTEN TEAM
Florida Blue - Blue Cross Blue Shield of Florida
Jacksonville, USA
09.2016 - 01.2022
- Provided administrative support for prior authorization and utilization management processes, assisting internal teams and providers as needed.
- Coordinated with internal departments to clarify information, support workflow efficiency, and maintain process compliance.
- Investigated and resolved member concerns, escalating complex issues according to company protocols.
- Maintained compliance with company policies and HIPAA regulations,safeguarding sensitive member information.
- Handled high-volume inbound calls, and emails maintaining professionalism and efficiency while resolving member concerns.
- Documented all member interactions and updates in internal systems, ensuring accuracy and compliance.
- Assisted members with benefits, eligibility, and general claims inquiries, ensuring accurate and timely responses
ACCOUNT SERVICES REPRESENTATIVE
ADT Security
Jacksonville, USA
10.2013 - 09.2016
- Managed customer accounts, billing, and contracts, enhancing client satisfaction and retention.
- Updated CRM for accuracy, ensuring compliance with company standards.
- Facilitated onboarding and training, boosting new hire productivity.
Education
High School Diploma -
Samuel W. Wolfson High School
Jacksonville, FLCoursework - Business Administration
Florida State College
Jacksonville, FLSkills
- Inbound/Outbound Call Handling
- Customer Service & Client Support
- CRM & Multi-System Navigation
- Conflict Resolution & Problem Solving
- High-Volume Call Center Experience
- Documentation & Accuracy
- Empathy & Active Listening
- Time Management & Organization
- Team Collaboration & Communication
Timeline
ANALYST II, QUALITY-PROCESS AUDITS
Florida Blue - Blue Cross Blue Shield of Florida
06.2024 - Current
ISSUE MANAGEMENT SPECIALIST
Florida Blue - Blue Cross Blue Shield of Florida
09.2023 - 06.2024
AGENCY ENGAGEMENT SPECIALIST
Florida Blue - Blue Cross Blue Shield of Florida
01.2022 - 09.2023
SERVICE ADVOCATE IV - DEDICATED WRITTEN TEAM
Florida Blue - Blue Cross Blue Shield of Florida
09.2016 - 01.2022
ACCOUNT SERVICES REPRESENTATIVE
ADT Security
10.2013 - 09.2016
High School Diploma -
Samuel W. Wolfson High School
Coursework - Business Administration
Florida State College
Similar Profiles
Abdo TaressaAbdo Taressa
Customer Service Representative at Florida Blue - Blue Cross Blue Shield Of FloridaCustomer Service Representative at Florida Blue - Blue Cross Blue Shield Of Florida
Christina FredericChristina Frederic
Medicare Appeals & Grievances Coordinator at Florida Blue - Blue Cross Blue Shield Of FloridaMedicare Appeals & Grievances Coordinator at Florida Blue - Blue Cross Blue Shield Of Florida
Mercedes RaysorMercedes Raysor
Clinical Support IV at Florida Blue - Blue Cross Blue Shield Of FloridaClinical Support IV at Florida Blue - Blue Cross Blue Shield Of Florida
Jacqueline JuergensenJacqueline Juergensen
Business Systems Analyst at Florida Blue - Blue Cross Blue Shield Of FloridaBusiness Systems Analyst at Florida Blue - Blue Cross Blue Shield Of Florida
JAMAL MACKJAMAL MACK
shift supervisor at Allied Universalshift supervisor at Allied Universal