Heavenly Sams
Tampa,FL
Summary
Detailed-oriented team player with 15 years of experience in customer service, compliance, and claims processing. Demonstrates strong skills in communication, training, and problem-solving, ensuring accurate eligibility determination and efficient claims management. Proven track record in supervising call centers and enhancing team performance through data-driven insights.
Overview
8
8
years of professional experience
Work History
Eligibility Specialist
Unum
10.2023 - Current
- Processed employee leave requests for FMLA and state regulations, ensuring compliance and accuracy.
- Facilitated positive customer interactions through timely resolution of inquiries, promoting a favorable service experience.
- Collaboratively promote a customer-oriented workspace through mentorship in eligibility assessments.
Clinical Admin Coordinator
United Health Group/NaviHealth
10.2022 - 08.2023
- Maintained member satisfaction through efficient management of administrative intake services for processing service requests.
- Collaborated with clinical teams to resolve inquiries from members and providers, enhancing overall service delivery.
- Provided exceptional customer service by addressing concerns and ensuring timely follow-ups.
Supervisor Customer Service
Leading Edge Administrators
06.2021 - 03.2022
- Directed and supervised team of 15 employees in daily operations.
- Led a high-volume call center, ensuring that customer service metrics were consistently met and exceeded.
- Developed and implemented training programs to enhance team members’ customer service skills.
- Analyzed call metrics to identify trends and improve service delivery, resulting in a 20% increase in customer satisfaction.
Supervisor Post-Acute Care
Carecentrix
03.2019 - 05.2021
- Ensured service level metrics were achieved through effective coaching and support.
- Managed escalated customer interactions, providing timely and effective resolutions.
- Recognized high-performing team members, fostering a culture of excellence in customer service.
Lead Network Services Advocate
CareCentrix
06.2016 - 03.2019
- Acted as the first point of contact for escalated customer issues, effectively resolving complex matters.
- Monitored team performance and developed action plans to enhance customer service quality.
- Analyzed and evaluated claim forms, medical reports, bills, and other documents to ensure accuracy of data.
Education
High School Diploma -
Middleton High School
Tampa, FL05-2006
Microsoft Data Analyst Associate Certification -
Hillsborough Community College
Tampa, FLSkills
- Customer Service
- Call Center
- Claims Processing
- Eligibility Determination
- Compliance
- Communication
- Problem Solving
- Data Entry
- Coaching
- Training
Timeline
Eligibility Specialist
Unum
10.2023 - Current
Clinical Admin Coordinator
United Health Group/NaviHealth
10.2022 - 08.2023
Supervisor Customer Service
Leading Edge Administrators
06.2021 - 03.2022
Supervisor Post-Acute Care
Carecentrix
03.2019 - 05.2021
Lead Network Services Advocate
CareCentrix
06.2016 - 03.2019
High School Diploma -
Middleton High School
Microsoft Data Analyst Associate Certification -
Hillsborough Community College
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