Earnestine Greene
Dallas,Texas
Summary
Results-driven Operations Specialist with extensive experience at Blue Cross Blue Shield of Texas, focusing on operations and customer support. Proven expertise in HIPAA compliance and leadership has led to enhanced process efficiency and elevated customer satisfaction. Adept in healthcare data analysis and relationship management, consistently surpassing performance targets while fostering strong stakeholder connections. Recognized for a resourceful approach to overcoming both routine and complex challenges, driving innovative solutions that streamline operations and boost productivity.
Overview
11
11
years of professional experience
Work History
Customer Advocate II/Provider Data Spec.(Hybrid)
Blue Cross Blue Shield of Texas
Richardson , Texas
05.2024 - 10.2024
- Provider Data Maintenance Specialist (Hybrid)
- Escalated complex customer cases as necessary to appropriate teams and departments.
- Process professional setup for medical new and existing groups, which entails keying IPO demos, creating designations, and updating CRM for IPS.
- Making sure that system rules for PPW are processed accurately and proficiently.
- There are rules for each type of professional, facility, and ancillary provider pertaining to setup.
- Provided customer support through phone, email and chat channels.
- Researched customer inquiries to ensure accurate resolution of their issues.
Quality Control/Shipping and Receiving Clerk
HEB Distribution Center
Plano , Texas
03.2023 - 11.2023
- Ensures that incoming shipments match records, such as invoices or manifest. Reviewing the loading and unloading of the transportation process. Documenting any issues or inefficiencies.
- Received incoming shipments, verifying quantity and quality of items against purchase orders.
- Maintained accurate records of all goods received and distributed in the warehouse.
- Ensured that stock was properly stored in designated areas according to safety regulations.
Sr. Quality Analyst/Sr. Customer Support (Remote)
Healthcare Staffing Ascend Ntl
Austin , United States
01.2020 - 11.2023
- Review and monitor the results of appeals for the escalation team as they are ticketed and prioritized.
- Assisted clients with the explanation of benefits.
- Claims management is effective and efficient in processing and communication between claimants and adjusters.
- Analyze the current customer service process, and identify gaps and/or defects to improve overall effectiveness.
- HIPAA law is effective on every call, protecting the privacy of clients.
- Developed and implemented quality assurance processes, procedures, and standards to ensure product quality.
- Conducted internal audits of production facilities to ensure compliance with safety regulations and industry standards.
- Reviewed customer feedback data to identify areas for improvement in product design and development.
Team Leader - CRM Operations
Teladoc, Inc
Lewisville , United States
10.2017 - 01.2020
- Administrative support in member services, assisting with authorization.
- Scheduled Medical Services for Registered Doctors and Pharmacists.
- Proficient in HIPAA laws, protocol maintained per the company's policy and procedure.
- Handled escalated clients via email or phone.
- File complaints or take other external actions.
- Developed and implemented CRM operations procedures to ensure customer satisfaction.
- Conducted regular meetings with team members to review performance and provide feedback.
- Monitored daily workflow of the CRM operations team, identified areas for improvement and took corrective action as needed.
Account Specialist
QVC San Antonio
San Antonio , United States
06.2015 - 10.2017
- Efficient service provider with high levels of accuracy.
- Operated A/R Tech Software.
- Negotiated payment plans for QVC Credit Member Services.
- Maintained quality services by monitoring system inputs and outputs, advising the supervisor of potential system issues.
- Developed and maintained customer accounts by accurately recording customer information.
- Analyzed financial data to identify discrepancies in account balances and ensure accuracy of records.
- Processed payments for customers, including credit card transactions, checks, wire transfers, and ACH payments.
Operations Specialist
Rent-A-Center Corporation
Plano , United States
08.2013 - 06.2015
- Responsible for the update of store maintenance and technical issues, working with a team at our Support Center.
- Processed invoices, approved purchase orders, and negotiated with vendors.
- Handled escalated calls for customers and employees.
- Assisted store employees, managers, and area managers with daily functions in stores, such as issues with trucks, deliveries, updated codes for safety, and store lockouts.
- Developed and maintained an efficient process for tracking inventory levels, ensuring accuracy of data.
- Analyzed customer feedback to improve operations processes and increase customer satisfaction.
- Conducted regular reviews of operational procedures to ensure compliance with company standards.
Education
Some College (No Degree) -
The College of Health Care Professions
TX08-2024
Bachelor of Science -
Texas A&M University
College Station, TX09-2016
Associate's Degree - Business
Texas A&M University
College Station, TX12-1990
Skills
- HIPAA (Health Insurance Portability and Accountability Act)
- Experience in leadership
- Customer Support Specialist
- Operations
- Talent Acquisition
- Purchase Orders
- Proficient in Medical Terminology
- Healthcare Data Analysis
- Claims Evaluation
- Insurance
- Documentation
- Total Rewards Strategy
- Prior Authorization
- Accounts Receivable Software
- Systems Administration/Management
- Quality Management
- Customer Acquisition
- Microsoft Remote Desktop Expertise
- Insurance Billing Management
- Technical Support
- Supply Chain Management
References
References available upon request.
Timeline
Customer Advocate II/Provider Data Spec.(Hybrid)
Blue Cross Blue Shield of Texas
05.2024 - 10.2024
Quality Control/Shipping and Receiving Clerk
HEB Distribution Center
03.2023 - 11.2023
Sr. Quality Analyst/Sr. Customer Support (Remote)
Healthcare Staffing Ascend Ntl
01.2020 - 11.2023
Team Leader - CRM Operations
Teladoc, Inc
10.2017 - 01.2020
Account Specialist
QVC San Antonio
06.2015 - 10.2017
Operations Specialist
Rent-A-Center Corporation
08.2013 - 06.2015
Some College (No Degree) -
The College of Health Care Professions
Bachelor of Science -
Texas A&M University
Associate's Degree - Business
Texas A&M University
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