Enthusiastic professional proficient in Customer Experience, Process Improvement and Quality Assurance through a career spent working with in various situations within business environments. Looking for a Compliance Specialist position that will bring continued success to an exemplary organization.
Overview
8
8
years of professional experience
Work History
Member Experience Associate Billing
Blue Cross Blue Shield MN
Eagan, MN
04.2023 - Current
Ensured compliance with company guidelines and regulatory standards when dealing with customers' accounts or policies as evidence by routinely excellent audit scores in both Billing and COB.
Researched relevant policy information to answer customer questions. Exceeded expectations by anticipating callers future needs and preventing future unnecessary call backs.
Verified accuracy of customer data entered into the system and updated when needed.
Collaborated with colleagues from other departments to resolve escalated customer issues.
Facilitated payment processing for premium payment efficiently.
Developed strong relationships with clients by providing exceptional customer service.
Conducted follow-up calls to ensure satisfactory resolution of customer issues.
Contractor
Aston Carter
Eagan, MN
11.2022 - 04.2023
Worked in Individual Billing and Medicare Billing at BCBS MN during this time.
Built trusted partnerships through open and interactive communication to earn positive customer feedback.
Researched relevant policy information to answer customer questions.
Ensured compliance with company guidelines and regulatory standards when dealing with customers' accounts or policies.
Verified accuracy of customer data entered into the system.
Facilitated payment processing for premium payments and renewals.
Assisted with resolving complex claims or billing disputes in a timely manner.
Quality Assurance Analyst
Advocate Aurora Health Care
Chicago, IL
10.2016 - 01.2020
Communicated regularly with management to discuss quality trends.
Conducted internal audits to measure adherence to established QA standards. Completed three audits weekly per agent for 40-50 agents. Often completed assignment early.
Used quality monitoring system to compile and track individual and team performance and communicated with the assigned supervisor monthly of trends.
Trained and led staff on proper QA standards by completing New Hire Orientation introduction to the quality team and assisted on the floor during EPIC system implementation.
Streamlined processes, increasing efficiency and consistency to support quality initiatives by increasing scheduling accuracy for Advocate Clinic at Walgreens by 75% and increasing patient satisfaction scores by 30%.
Utilized client satisfaction surveys to improve service quality.
Recommended improvements to systems and procedures for increased productivity.
Benefits Team Lead- Mid Market/National Accounts at Blue Cross Blue Shield of MN-Coupe HealthBenefits Team Lead- Mid Market/National Accounts at Blue Cross Blue Shield of MN-Coupe Health
Business System Analyst at Blue Cross Blue Cross Blue Shield of Tennessee (Facets Billing)Business System Analyst at Blue Cross Blue Cross Blue Shield of Tennessee (Facets Billing)