LA SANDRA TOWNSEND
Rockford,IL
Summary
Personable and dedicated Customer Service Representative with extensive experience in Customer Service in Health Care industry. Solid team player with upbeat, positive attitude and proven skill in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Articulate, enthusiastic and results-oriented with demonstrated passion for building relationships, cultivating partnerships and growing businesses.
Overview
17
17
years of professional experience
Work History
Customer Service Representative
Angle Health (for Jacobson Group)
Salt Lake City, UT
11.2023 - 02.2024
- Answered inbound customer's and provider's inquiries over the phone and via email/chat. Provided accurate information regarding benefits, services, and explain in detail how a claim processed.
- Provided excellent customer service to resolve customer's or provider's issues in a timely manner and maintain quality goals.
- Followed up on customer's and provider's inquiries not immediately resolved by providing timely updates on the status of their requests.
- Assisted customers in navigating through website features and functions to locate desired information or benefits.
- Process or adjust claims.
Customer Service
Cobalt Medplans (Blue Cross Blue Shield Provider)
Overland Park, KS
03.2022 - 07.2023
- Respond to phone call requests for benefits by evaluating and determining coverage for benefits based on the member’s plan/client’s benefit plan .
- Respond to phone call inquiries regarding the processing of a claim .
- Researches policy information and membership records to resolve issues .
- Maintain quality and production standards as defined by client contract and/or management determination of need .
- May also process claims or adjustments.
Customer Advocate II
Blue Cross Blue Shield Of Illinois
Rockford, IL
07.2018 - 03.2021
- Delivered an exceptional level of service to each member by listening to concerns and answering questions pertaining to medical benefits and provider's billing
- Ensured that appropriate coding is managed to maximize efficiency
- Retained strong medical terminology understanding in effort to better comprehend procedures
- Experienced in evaluating customers situations, making decisions, and responding quickly to questions
- Process and adjust claims to ensure integrity in billing and coding
- Resolve member's issues with claims being coded incorrectly
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- Demonstrated excellent communication skills in resolving product and consumer complaints.
- De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
- Educated customers on special pricing opportunities and company offerings.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Communicated with healthcare personnel, including practitioners to promote accuracy.
Production Team Lead
PCI PHARMA SERVICES
Rockford, IL
11.2016 - 01.2018
- Insured all employees adhered to all applicable regulations, policies and procedures for health, safety and environmental compliance
- Prepared operational reports and provide information to upper management
Team Lead
CONAGRA/TREEHOUSE FOODS
South Beloit, WI
07.2016 - 10.2016
- Supervised team of 25 skilled packers, machine operators, floaters and palletizers helping them package the companies product according to standard operation procedures and quality guidelines
- Reviewed the performance of staff
Supervisor
SERVICOM (Comcast Service Provider)
Rockford, IL
08.2015 - 04.2016
- Successfully managed a team of 50 members
- Coached team on their individual KPI metrics
- Addressed negative customer feedback immediately
- Effectively communicated with team members to maintain clearly defined expectations
- Developed and implemented policies, procedures and process improvement initiatives to improve retention rates and increase customer satisfaction
- Interpersonal and analytical skills
Lead Supervisor
APAC (Verizon Wireless Service Provider)
Rockford, IL
02.2014 - 08.2015
- Motivated and promoted team employees from within for key leadership roles.
- Met call center financial objectives by estimating requirements and preparing annual budgets.
- Determined and formulated policies, procedures and business strategies to meet growth objectives of company.
- Conducted periodic performance reviews to determine employee eligibility for merit increases and bonuses.
- Accomplished call center resource objectives by recruiting, selecting and orienting new employees.
- Monitored performance by reviewing relevant reporting data and producing statistical reports.
- Delegated work to staff, setting priorities and goals.
- Created, recommended and implemented policies and procedures for operational and staffing resources.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- Completed thorough opening, closing and shift change functions to maintain operational standards each day.
- Planned and delivered training sessions to improve employee effectiveness and address areas of weakness.
- Produced thorough, accurate and timely reports of project activities.
- Resolved customer inquiries and complaints requiring management-level escalation.
- Interviewed prospective employees and provided input to HR on hiring decisions.
- Evaluated individual and team business performance and identified opportunities for improvement.
- Organized team activities to build camaraderie and foster pleasant workplace culture.
- Planned and led team meetings to review business results and communicate new and ongoing priorities.
- Assigned work and monitored performance of project personnel.
- Analyzed business performance data and forecasted business results for upper management.
- Held regular one-on-one meetings with employees to review performance and priorities and provide feedback.
- Mediated conflicts between employees and facilitated effective resolutions to disputes.
- Reviewed completed work to verify consistency, quality and conformance.
- Successfully managed the of 23 team members
- Interviewed, hired and trained new qualified customer service representatives
- Provided detailed monthly departmental reports and updates to senior management
- Addressed negative customer feedback immediately
- Provided a high level of product and leadership support to representatives and clients
- Routinely prepared and evaluated KPI reports to identify problems and areas for improvement
- Effectively communicated with team members to maintain clearly defined expectations
- Clear and concise verbal and written communication skills
Supervisor/Team Lead
SERVICOM (Comcast Service Provider)
Machesney Park, IL
07.2013 - 02.2014
- Develop, implement and monitor programs to maximize customer satisfaction and manage on-site customer service representatives
- Interviewed, hired and trained new quality customer service representatives
- Presented detailed monthly departmental reports and updates to senior management
Admissions Counselor
COLORADO TECHNICAL UNIVERSITY, College/University
Schaumburg, IL
04.2010 - 02.2013
- Conducted detailed interviews with prospective students
- Evaluated prospective students needs, interest and qualifications while providing clear and concise information to help them make an informed decision
Call Center Supervisor
NCO (A T-Mobile Service Provider)
Rockford, IL
04.2007 - 06.2009
- Monitored teams activity daily, reviewed and distributed team performance statistics reports to agents and upper management weekly
- Responsible for hiring and disciplinary discharged workers, also issued written and oral instructions
- Consistently received recognition and compensation for high customer services levels
Education
High School Diploma -
East High School
Rockford06-1986
BBA - BUSINESS MANAGEMENT
Rockford Career College
Skills
- Team Management
- Data Analytics
- Strategic Planning
- Staff Management
- Operations Management
- Staff Development
- Financial Management
- Processes and Procedures
- Process Monitoring and Improvement
- Policy Enforcement
- Employee Motivation
- Staff Discipline
- Complex Problem-Solving
- Training and Mentoring
- Goal-Oriented
- 30 years in Customer Service
- 20 Years in Management
- 6 Years Billing and Coding
- 6 Years in Processing Medical Claims for Commercial, Medicaid, Medicare, Professional, and Facility claims
- 6 Years Health Care Benefits for Medical, Behavior Health, Vision, and Dental
Timeline
Customer Service Representative
Angle Health (for Jacobson Group)
11.2023 - 02.2024
Customer Service
Cobalt Medplans (Blue Cross Blue Shield Provider)
03.2022 - 07.2023
Customer Advocate II
Blue Cross Blue Shield Of Illinois
07.2018 - 03.2021
Production Team Lead
PCI PHARMA SERVICES
11.2016 - 01.2018
Team Lead
CONAGRA/TREEHOUSE FOODS
07.2016 - 10.2016
Supervisor
SERVICOM (Comcast Service Provider)
08.2015 - 04.2016
Lead Supervisor
APAC (Verizon Wireless Service Provider)
02.2014 - 08.2015
Supervisor/Team Lead
SERVICOM (Comcast Service Provider)
07.2013 - 02.2014
Admissions Counselor
COLORADO TECHNICAL UNIVERSITY, College/University
04.2010 - 02.2013
Call Center Supervisor
NCO (A T-Mobile Service Provider)
04.2007 - 06.2009
High School Diploma -
East High School
BBA - BUSINESS MANAGEMENT
Rockford Career College
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