Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Provider Account Liaison
Highmark BlueShield Of Northeastern New York
04.2015 - 04.2024
Primary contact for the development of relationships between provider groups and facilities.
Provided quality service and education to clients to maintain an adequate provider network.
Takes ownership and manages strategic business projects as assigned.
Enhanced client relationships by consistently providing exceptional service and support.
Assisted in the onboarding of practitioners, facilitating smooth transitions and building strong foundations for future growth.
Fostered lasting relationships with customers through effective communication and quick response, resulting in long-term loyalty.
Performed the BlueCross and BlueShield Association Data auditing.
Performed Provider Network Data System (PNDS, NYS Department of Health directory audits for Commercial, Exchange and Dental lines of business.
Quality Coach
Highmark BlueShield Of Northeaster New York
07.2012 - 04.2015
Internal monitoring and auditing of the State and Federal enrollment.
Monitored telephone, correspondence and claim adjustment transactions.
Provided timely, clear and concise feedback electronically, verbally and in written format
Monitored key performance indicators to track progress toward quality objectives and adjust strategies as needed.
Established and tracked quality department goals and objectives.
Recorded, analyzed, and distributed statistical information.
Applied coaching techniques and tools to support managers and team members in improving performance.
Produced quality reports to management, assisting in identification and development of the audited staff.
Customer Service Representative
Highmark BlueShield Of Northeastern New York
11.2002 - 07.2012
Handled customer inquiries and suggestions courteously and professionally.
Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
Answered constant flow of customer calls with minimal wait times.
Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
Utilized customer service software to manage interactions and track customer satisfaction.
Provided coaching and mentoring to new hires, contributing to their successful integration into the team.
Tracked customer service cases and updated service software with customer information.
Participated in cross-functional initiatives aimed at enhancing overall business operations and customer satisfaction levels.
Claim adjustment experience.
Educated customers about billing, payment processing and support policies and procedures.
Trained new personnel regarding company operations, policies and services.
Bank Teller
Charter One Bank
07.2001 - 11.2002
Managed high-volume transactions during peak hours while maintaining attention to detail, ensuring seamless customer experience.
Balanced cash drawers accurately at the end of each shift, minimizing discrepancies in financial records.