Over 23 years' industry background with dedicated service to one of the nation's leading healthcare providers, Blue Cross Blue Shield. Dependable, hard working troubleshooter, experienced in analyzing and resolving healthcare related claims issues with confidence to deliver win-win outcomes. Direct career experience in customer relations, delivering service excellence with a proven track record of success in helping others and always going above and beyond the call of duty to get the job done.
Proficient at coordinating personal and team work efforts to ensure integration and completion of work against expectations. Ability to liaise and communicate at virtually all levels and environments from grass roots to senior management.
Quick thinking and analytical during difficult situations; equipped to problem solve and make decisions with confidence.
Overview
25
25
years of professional experience
Work History
Guest Service Advocate
Target
04.2022 - Current
Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.
Developed strong product knowledge to provide informed recommendations based on individual customer needs.
Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
Accounting IIIa
Florida Blue
08.2010 - Current
Processing refund checks on PeopleSoft Accounts Receivable Financial System
Streamlined counting procedures for increased speed and productivity in high-volume environments.
Providing pivotal support to with research and cash posting functions
Serve as subject matter expert across all claims functions and matters relating to claims adjustments and provide refunds
Well-known for the ability to resolve provider issues and functions as escalation point to management
Performs as training specialist on various initiatives including healthcare provider audits and all PeopleSoft Accounts systems
Progressed to positions of increased responsibility and team leadership during this current 23-year tenure.
Service Advocate / Many positions
Blue Cross Blue Shield of Florida
09.1998 - 08.2010
Leveraged people skills for a busy inbound call center while ensuring compliance with the quality agenda
Proactively expanded role to function as subject matter expert for new hire training and lent pivotal support to many other areas & business units
Led several process improvement initiatives to optimize overall performance
Promoted for the ability to improve ineffectual processes, facilitate various training initiatives and drive quality standards
Assigned daily schedules for team members and trainees
Recognized for generating highly accurate daily inventory reports for management review
Advised the operations manager and OE analyst on projects involving complex provider matters
Chosen to partner with senior managers to deliver seamless side-by-side training and audit function.
Improved customer satisfaction by promptly addressing inquiries and resolving issues.
Managed high call volumes while maintaining quality service standards and positive customer interactions.
Assisted in training 50 new employees, sharing best practices for achieving success on a new protocol.
Education
Associate of Science - American Sign Language (ASL)
Florida State College of Jacksonville
Jacksonville, FL
03.2023
Pharmacy Technician Diploma - Pharmacy Technician
Penn Foster Career College
Jacksonville, FL
08.2011
Skills
Technology Learning
PeopleSoft Accounting Software
All Microsoft Office Programs
Mentorship
Client Representation
Document Review
Research Proficiency
Critical thinking
Time management
Timeline
Guest Service Advocate
Target
04.2022 - Current
Accounting IIIa
Florida Blue
08.2010 - Current
Service Advocate / Many positions
Blue Cross Blue Shield of Florida
09.1998 - 08.2010
Associate of Science - American Sign Language (ASL)