Erin Bell
Houston,TX
Summary
Grievance Coordinator with extensive experience in managing and resolving customer complaints. Proven ability to communicate effectively, negotiate solutions, and solve problems efficiently. Enhanced customer satisfaction through the implementation of targeted resolution strategies in previous positions.
Overview
15
15
years of professional experience
7
7
years of post-secondary education
Work History
Medicare Grievance Coordinator
Cigna
Houston, TX
02.2024 - Current
- Review incoming grievances for complete categorization and description of complaint.
- Investigate root cause of customer dissatisfaction through research using multiple systems and performing call reviews.
- Provide customers with their appeal, coverage determination, and other Medicare rights and options available to them through phone calls and/or written resolution.
Owner/Consultant
Purple Growth Enterprise
Sacramento, California
01.2018 - Current
- Consulted and advised organizations to help clients improve their business performance in terms of operations and management with an emphasis on staff morale and customer service.
- Provided guidance, motivation, emotional support, and role modeling to individuals and companies with compassion.
Licensed Medicare Sales Agent
TTEC
Houston, TX
06.2023 - 12.2023
- Answer incoming communications from customers to assess needs for enrollment into Medicare plans for Annual Enrollment Period (AEP).
- Determine eligibility and provide guidance for special election periods available outside of annual change period.
- Work within set KPI standards to achieve 95% reliability score for calls.
Sr. Compliance Specialist
Texas Children's Health Plan
Bellaire, TX
04.2022 - 11.2022
- Identifies issues through data analyzing and regulation comparison to determine if health plan departments are within compliance and NCQA standards.
- Reviews policies and procedures to verify accuracy and appropriateness as well as updates being made on timely basis per regulatory cadence.
Child Protective Investigator
State of Texas Child Protective Services
Houston, TX
08.2021 - 12.2021
- Investigating allegations of child abuse and neglect.
- Working with law enforcement on joint investigations.
- Referring children to community resources that promote their safety and well-being.
- Volunteer and assist in the fight against human trafficking.
Contact Tracer 2 Consultant
Purple Growth Enterprise
Houston, TX
01.2021 - 04.2021
- Conducting initial and follow-up interviews by making outbound calls to people who tested positive for COVID-19.
- Maintain assignment spreadsheet.
- Summarize medical records and labs for patient records.
Outpatient Supervisor
WellCare
Houston, TX
01.2019 - 09.2020
- Manage a team of 11 (Remote) Outpatient Coordinators in accordance to company policy and procedure. Track and update time cards, manage inventory and production/assigning.
- Identify and suggest improvement for current processes through audits. Make and update job aids and reports for team and management.
Clinical Operations Manager
EnvisionRx
El Dorado Hills, CA
12.2016 - 08.2017
- Manage 57 direct reports in accordance with company policies through major corporate changes while also co-managing an additional team of 26 in Ohio.
- Manage the coverage determination process from start to finish for efficiency and resolution of process issues.
- Research claim reject messaging for proper categorization before pharmacist review.
Member Relations Supervisor
Western Health Advantage
Sacramento, CA
01.2016 - 08.2016
- Managed staff in Member Relations Unit to ensure timely processing of member appeals and grievances.
- Ensured compliance with DMHC and NCQA requirements, meeting all deadlines.
- Collaborated with Medical Management Departments and Compliance to prevent fraud, waste, and abuse.
- Developed job descriptions for promotional advancements within the team.
- Transitioned team to Salesforce platform, enhancing operational efficiency.
Provider Services Sr Consultant
Cigna
Franklin, TN
12.2013 - 06.2014
- Responsible for incoming telephonic provider support, handling provider inquiries, questions and complaints.
- Monitor and track service issues and inquiries.
- Provide continuing education of providers.
Pharmacy Support Call Center Supervisor- CPhT
Windsor Health Plan
Brentwood, TN
11.2010 - 07.2013
- Supervised daily operations of Medicare Part D Customer Service Call Center team of 23 members.
- Developed and analyzed performance standards aligned with company KPIs.
- Trained and mentored staff to enhance skills and service quality.
- Initiated grievance and appeals team pilot, identifying fraud, waste, and abuse.
- Collaborated with pharmacists and leadership during CMS audits to ensure compliance.
- Acted as liaison between health plan and PBM for effective communication.
Education
State Certified LTC Ombudsman - Harris County Long-Term Care Ombudsman Program
UT Health Houston
07.2024 - 07.2025
Bachelor of Science - Health Administration
University of Phoenix
Nashville, TN 03.2016 - 12.2018
Certificate - Professional Life And Career Coaching
UC Davis
Sacramento, CA 01.2018 - 12.2018
Associate Of Applied Science - Pharmacy
Carrington College
Sacramento, CA 03.2006 - 12.2008
Skills
- Call center management
- Medicare compliance
- Training and mentoring
- KPI analysis
- Call auditing
- Customer relationship management
- Conflict resolution
- Process improvement
- Time management
- Inclusive leadership
- Policy analysis
- Grievance procedures
- Team collaboration
Timeline
State Certified LTC Ombudsman - Harris County Long-Term Care Ombudsman Program
UT Health Houston
07.2024 - 07.2025
Medicare Grievance Coordinator
Cigna
02.2024 - Current
Licensed Medicare Sales Agent
TTEC
06.2023 - 12.2023
Sr. Compliance Specialist
Texas Children's Health Plan
04.2022 - 11.2022
Child Protective Investigator
State of Texas Child Protective Services
08.2021 - 12.2021
Contact Tracer 2 Consultant
Purple Growth Enterprise
01.2021 - 04.2021
Outpatient Supervisor
WellCare
01.2019 - 09.2020
Owner/Consultant
Purple Growth Enterprise
01.2018 - Current
Certificate - Professional Life And Career Coaching
UC Davis
01.2018 - 12.2018
Clinical Operations Manager
EnvisionRx
12.2016 - 08.2017
Bachelor of Science - Health Administration
University of Phoenix
03.2016 - 12.2018
Member Relations Supervisor
Western Health Advantage
01.2016 - 08.2016
Provider Services Sr Consultant
Cigna
12.2013 - 06.2014
Pharmacy Support Call Center Supervisor- CPhT
Windsor Health Plan
11.2010 - 07.2013
Associate Of Applied Science - Pharmacy
Carrington College
03.2006 - 12.2008
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