Results oriented customer service specialist with over 20+ years of demonstrated success in achieving superior quality assurance and customer satisfaction. Highly effective in partnering with other department groups to develop and implement new programs/ procedures to enhance performance and workflow efficiencies. Recognized as a department leader who leads by example and inspires peers to reach peak performance. Strong communication and multi-tasking skills with the ability to work well under pressure. Skilled in identifying problems and resolving complex issues.
Overview
22
22
years of professional experience
Work History
Member Service Representative
Kaiser Permanente
05.2014 - Current
Increase customer satisfaction and retention by providing members, customers, patients, and providers with accurate, consistent, timely, and meaningful information
Build rapport and collaborative relationships with current and prospective members in accordance with compliance guidelines
Be available to handle member inquiries
Represent Health Plan by answering and documenting all incoming contacts to determine their nature, and respond to complex calls related to specialized product lines or ques
Respond with empathy to complaints and concerns from members concerning health plan benefits, account status, payment history, and medical services
Initiate contact with the appropriate health plan, medical group and facility personnel to obtain information relevant to the concern or inquiry as needed
Evaluate data to determine and implement the appropriate course of action to resolve the complaint and/or coordinate service recovery
Document according to procedure
Assist department in reaching call handling goals, first contact resolution goals, complaint resolution compliance, member retention and making return contact as warranted
Complete required training (including, but not limited to, annual certifications) and understand how to use tools available to recall necessary information
Effectively diffuse anger, tension, and hostility, within regulatory guidelines, of members expressing concerns about KP
Patient Service Lead
Preferred Homecare - Lifecare Solutions
02.2014 - 05.2014
Company Overview: https://www.indeed.com/cmp/Preferred-Homecare?campaignid=2pane-name&from=2pane&fromjk=8150070139e837c4&jcid=ee213e90158419db
Process all patient orders accurately, thoroughly and in a time-sensitive manner
Communicate in a timely manner to all stakeholders
As a Patient Service Specialist, I am the voice of the organization and the primary resource for patients and physicians to obtain information and answers to questions
Proficient in and performs all Patient Service Associate and Specialist core responsibilities
Responds to telephone inquiries and orders from patients and referral sources
May assist walk-in patients with the selection of equipment, supplies, and services
Determines resolution of patient and referral inquiries, questions, or concerns
Identifies concerns and ensures they are recorded in Concern Tracker system when appropriate
Completes electronic intake process in billing system, performs verification of insurance, and reviews all documentation for accuracy and to qualify patient for services
Contacts patients to inform them of any patient payment requirements, collects payment, and determines best delivery method and provides instructions for receiving delivery
Understands and abides by Accreditation Commission for Health CarACHC) requirements
May need to understand and interpret Medicare guidelines and qualifying documentation
Thoroughly understands payer and utilization guidelines
May process insurance authorization and follow up on requests as needed
Establishes positive relationships with referral sources and builds rapport with internal and external customers
May be required to perform quality assurance process confirming accuracy of orders prior to submission for reimbursement
Understands C-PAP compliance guidelines as required by assignment or has obtained knowledge of rehab specialty equipment and coverage criteria
Consistently meets Quality Assurance score of 85% or above
Responsible to provide coverage in all areas of assigned department as needed
Sets the working example for other Patient Service employees in business acumen and knowledge
Responsible for completing departmental projects as assigned
Communicated on a daily basis with Mortgage Advisors, Title Companies and third party vendors providing counsel, advice and recommendations of loan status and requested required information
Successfully reviewed loan documentation for accuracy and proactively resolved complex customer issues to consistently meet 100% in compliance
Coordinate conference calls with Mortgage Advisors
Responsible for reviewing and filing incoming mail, send outgoing mail to clients and request checks for third party vendors
Handles and maintains confidential information, documents and reports
Prepare and sort daily reports for management and distribute to peers with process and procedure to complete
Ranked #1 (out of 38) in the department setting new record closing 28 loans vs
Goal of 14 achieving 200% of plan
Personally selected by senior management to represent the Irvine site to participate in the Centralized Insurance Team Project
Designed and implemented a new website for loans submitted for flood insurance which minimized costs to the bank and was consequently rolled out across the country
Coached, mentored and conducted side-by-side training sessions with underperforming peers
Improved quality scores from 90% to 98% within 30 days resulting in a 108% improvement
Served on a special EC Project that improved efficiencies between the Processors and the Title Company by decreasing the number of emails and correspondence
Project was so successful; it was rolled out across the company
Consistently maintained 98% QA scores on all files reviewed
Demonstrated thorough knowledge of investor lending requirements, lending policies, guidelines and systems in order to ensure timely and accurate loan processing
Exercised judgment within guidelines to meet client needs
Successfully communicated (inbound/ outbound calls) available options to borrowers to resolve delinquency or immediate default
Prepared files for underwriting and informed borrowers of any additional documentation needed for processing
Consistently ranked #1 (out of 40) in overall balanced scorecard for quality and production
Achieved 142% of goal processing 20+ loans per month vs
Goal of 14
Department leader; received 2 'Employee of the Month Awards' for top performance and customer satisfaction
Selected by management to train, coach and develop peers to improve performance
Worked closely with the training department to improve workflow processes and product knowledge
Ranked #1 in achieving the highest training scores during transition from Customer Assistant Specialist to Senior Loan Processor
Achieved 100% quality scores every month providing exceptional customer service
Successfully ensured that wrap time was to a minimum maintaining excellent service levels
Effectively prioritized workload daily
Proactively remained knowledgeable of borrower’s hardship and communicated ongoing file status and final decision to borrowers in a timely manner
Collected bank statements, stocks and bonds for asset qualifications and completed income calculations for possible approval or denial on loan modifications
Collector II
Wells Fargo Home Mortgage
11.2007 - 05.2010
Maintained a high level of customer service throughout every call
Proactively evaluated each borrowers unique financial situation and customized solutions with recommended options
Worked with borrowers in calculating their total income, all debts and any other finances
Set borrowers up on repayment plans, special forbearances and loan modifications that were affordable and suitable for each individual
Monitored wrap time, workload and overall call efficiency, which increased customer satisfaction resulting in 100% quality scores
Successfully handled the dialer switchboard and achieved superior service levels
Viewed as a 'Go-To' person and subject matter expert in the department
Conducted side-by-side coaching for peers and handled escalation calls
Responsible for answering inbound and outbound calls from Wells Fargo Home Mortgage customers in regards to their home mortgage accounts
Escrow Advisor
Financial Title & Escrow
08.2005 - 09.2007
Welcomed clients, answered multiple phone lines, prepared reports and completed various data entry tasks
Provided exceptional customer service to clients and handled borrowers questions or concerns
Reviewed title policies for any mortgages and liens on the property
Ordered demands from mortgage companies and lien holders
Reviewed final loans documents received from Lenders and Brokers to make sure documents were accurate before contacting client for loan signing
Packaged documents and sent back to Lenders and Brokers after signed
Remained in constant communication with Lenders, Brokers and borrowers throughout the close of escrow
Closed and balanced out file
Processor, Underwriting, Doc Drawer, Funder
Countrywide Home Loans
08.2003 - 07.2005
Assisted customers with issues and concerns throughout the entire process of their mortgage loan
Welcomed clients and answered multiple phone lines preparing reports and data entry
Sent upfront disclosures out to clients requesting all documentation necessary to process loan
Reviewed documentation once received back from clients to approve or decline the loan
Ordered estimated and final HUD-1 from Escrow Company
Drawed final loan documents and set up signing with notary
Remained in constant communication with clients, escrow and loan officers throughout the process of the loan closing
Audited final loan documents, sent wire to title and shipped original file to post closing