CHRISTINA GOODMAN
Balch Springs,TX
Summary
Customer Experience and Operations professional with over 5 years of experience in regulated healthcare environments at UnitedHealthcare and Optum. Experienced in high-volume call environments, structured documentation workflows, and compliance-driven processes. Proven ability to meet performance metrics (93.5% FCR, 90% NPS) while protecting PHI and maintaining quality standards in remote settings.
Overview
18
18
years of professional experience
Work History
Customer Experience Lead
Optum
03.2025 - Current
- Case Research & Documentation Management: Utilize system tools and documentation workflows to prioritize escalated cases and ensure accurate resolution of complex financial benefit issues.
- Complex Case Resolution: Resolve high-complexity member and employer cases involving eligibility, account funding (FSA, HSA, HRA), and transaction discrepancies requiring cross-system investigation and documentation validation.
- Performance Metrics: Sustain 93.5% First Call Resolution (FCR) and 90% Net Promoter Score (NPS) in a production-driven, metric-based environment; consistently recognized for resolution quality.
- Process Improvement Contributions: Submitted workflow improvement recommendations that were incorporated into broader operational processes to improve documentation accuracy and case efficiency.
- Cross-Team Collaboration: Participated in knowledge-sharing sessions to support workflow consistency and documentation standards across teams.
Senior Customer Service Representative
Optum
02.2024 - 03.2025
- Benefit Resolution: Managed supplemental financial benefits (food, OTC, utilities), resolving payment processing discrepancies and vendor-related issues through detailed case research and documentation review.
- High-Volume Call Management: Handled structured daily call volumes in a production-based environment, ensuring timely case resolution and accurate documentation.
- Member Guidance & Follow-Up: Guided members through digital benefit platforms and conducted follow-up outreach when required to obtain additional information or clarify eligibility issues.
- Regulatory Compliance: Operated within CMS-regulated workflows to ensure adherence to policy guidelines, transaction accuracy, and protection of PHI.
Post Call Production Lead
UnitedHealthcare
02.2022 - 02.2024
- Case Review & Documentation Validation: Reviewed completed member cases to identify documentation gaps, policy misinterpretations, and processing errors prior to final resolution.
- Follow-Up Coordination: Conducted structured follow-up with members and internal stakeholders to obtain missing information and ensure accurate case completion.
- Quality Assurance Support: Aligned case handling with QA standards by identifying recurring documentation trends and contributing to corrective workflow adjustments.
- Compliance Monitoring: Ensured adherence to CMS guidelines and PHI protection standards during post-call case review and processing.
- Tracking & Reporting: Utilized Microsoft Excel to monitor unresolved cases and ensure adherence to established resolution timelines.
Senior Customer Service Representative
UnitedHealthcare
02.2021 - 02.2022
- Complex Case Resolution: Resolved complex benefit and claim inquiries requiring contract interpretation and detailed plan review.
- Member Education & Plan Review: Guided members through plan documents to clarify coverage expectations, benefit limitations, and eligibility requirements.
- Provider Communication Support: Facilitated communication between members and healthcare providers regarding coverage guidelines and documentation requirements.
- De-escalation & Compliance: Managed escalated concerns while adhering to CMS regulatory workflows and protecting PHI in all case handling activities.
Senior Collections Specialist
Flagship Credit Acceptance
10.2019 - 12.2020
- Case Review & Documentation Validation: Reviewed completed member cases to identify documentation gaps, policy misinterpretations, and processing errors prior to final resolution.
- Follow-Up Coordination: Conducted structured follow-up with members and internal stakeholders to obtain missing information and ensure accurate case completion.
- Quality Assurance Support: Aligned case handling with QA standards by identifying recurring documentation trends and contributing to corrective workflow adjustments.
- Compliance Monitoring: Ensured adherence to CMS guidelines and PHI protection standards during post-call case review and processing.
- Tracking & Reporting: Utilized Microsoft Excel to monitor unresolved cases and ensure adherence to established resolution timelines.
Senior Banking Operations Processor
First Horizon Bank
02.2008 - 05.2019
- Regulatory Transaction Processing: Managed daily check processing and Check 21 digital conversions, ensuring accuracy in MICR data validation within compliance-driven banking systems.
- Documentation & Tracking Controls: Developed structured tracking logs to improve transaction accountability and support internal audit review processes.
Education
High School - undefined
Whitehaven High School
Memphis, TennesseeSkills
High-Volume Call Management (40 Daily Interactions)
Stakeholder Communication
Structured Member & Internal Follow-Up
Quality Assurance (QA) Standards
PHI / HIPAA Compliance
Regulatory Policy Interpretation
Case Research & Documentation
Complex Case Resolution
Salesforce CRM
ServiceNow
NICE CXone
Microsoft Excel
Familiarity with Genesys Cloud
Financial Transaction Accuracy
Root Cause Analysis
Accomplishments
Nominated as a top contributor to process improvement by submitting ideas to make process easier for both agents and members.
Personal Information
Timeline
Customer Experience Lead
Optum
03.2025 - Current
Senior Customer Service Representative
Optum
02.2024 - 03.2025
Post Call Production Lead
UnitedHealthcare
02.2022 - 02.2024
Senior Customer Service Representative
UnitedHealthcare
02.2021 - 02.2022
Senior Collections Specialist
Flagship Credit Acceptance
10.2019 - 12.2020
Senior Banking Operations Processor
First Horizon Bank
02.2008 - 05.2019
High School - undefined
Whitehaven High School