Jalesa Floyd

• Manages multiple tasks lists in accordance with directed timelines
• Meets call volume, chat volume, schedule adherence, quality, Veteran appointment and other production standards
• Initiates and receives phone calls, chat messages and emails from VA medical center staff, and providers to answer claims, eligibility, and benefit and program questions
• In select markets, facilitates appointment scheduling of Veterans through outbound solicitation to providers
• Records preferences, tracks Veteran questions thoroughly in the TriWest's Customer Relationship Management systems and Portal, as well as VA's HSRM systems
• Consistently displays professional and courteous service skills to internal and external customers
• Accurately resolves VA and provider inquiries with a focus on first call resolution
• Protects the privacy of health information of patients when using or disclosing Protected Health Information (PHI)
• Takes appropriate measures to comply with HIPAA regulations to protect privacy of customers' health information
• Documents all communications involving Veteran and provider contacts
• Uses critical thinking in problem solving and follows established processes to assure quality program compliance
• Consistently meets department productivity and performance metrics to include regular and consistent attendance
• Participates in cross training, employee development and flexible assignments to ensure business needs are met

• Determines covered insurance losses by studying provisions of a policy or certificate
• Establishes proof of loss by studying documentation and assembling additional information from outside sources
• Documents specific claims by completing and recording forms, reports, logs, and records
• Analyzes insurance claims to prevent fraud
• Prepares reports by collecting, analyzing, and summarizing information
• Resolves claims by approving or denying documentation, calculating benefits due, and determining compensation settlement
• Ensures legal compliance by following company policies, procedures, and guidelines, as well as state and federal insurance regulations
• Maintains quality customer service by following customer services practices and responding to customer inquiries
• Provides legal support by assembling documentation for settlement action
• Protects operations by keeping claims information confidential
• Maintains a good relationship with insurance departments

• Applicant Onboarding

• Applicant Interviews

• Applicant background checks/ TB SKIN TEST

• Assist the CEO & Branch Manager With Daily Tasks.

• Applicant Hiring

• Greeted clients and visitors, enhancing overall customer service experience. Managed appointment scheduling to ensure smooth daily operations.
• Directed phone calls to appropriate departments, improving communication efficiency. Assisted in maintaining clean and organized reception area for a welcoming environment.
• Responded to inquiries promptly, providing accurate information to clients. Monitored office supplies inventory, placing orders to maintain stock levels.
• Learned and adapted quickly to new technology and software applications. Used critical thinking to break down problems, evaluate solutions and make decisions.
• Demonstrated strong organizational and time management skills while managing multiple projects.
• Developed and maintained courteous and effective working relationships.

• Ensures effective customer relations by responding accurately, timely and courteously to telephone, written, web, or walk-in inquiries
• Accurately documents inquiries
• Initiates or processes adjustments or performs other research as needed to resolve inquiries
• Coordinates with other departments to resolve problems
• Responds to, researches and/or assists with priority inquiries and special projects as required by management
• Provides feedback to management regarding customer problems, questions and needs
• Maintains accurate records on complaints and/or other customer comments, and makes recommendations for changes to management
• Follows through on complaints until resolved or reports to management as needed
• Maintains basic knowledge of quality work instructions and company policies
• Assists with process improvements through the recommendation of changes in procedures and techniques discovered during daily operations
• Maintains all departmental productivity, quality, and timeliness standards
• Identifies and promptly reports and/or refers suspected fraudulent activities and system errors to the appropriate departments

• Manually sort mail for shipping

• Gather facts and evidence to determine if someone is eligible for benefits
• Help the public by answering a wide variety of questions both in-person and by telephone

• Stock merchandise for the pickers to package, for shipping to all company stores

• Prepare all freight for shipping
• Load & unload trucks

• Provide security services to a professional office building
• Security dispatcher at Brookwood Mall
• Monitor CCTV

• Prepare specimens for routine lab testing

• Sorted, organized, & prepared all mail for shipping