Lesley Gallegos
Elizabethtown,KY
Summary
Experienced leader with strong background in guiding teams, managing complex projects, and achieving strategic objectives. Excels in developing efficient processes, ensuring high standards, and aligning efforts with organizational goals. Known for collaborative approach and commitment to excellence.
Overview
16
16
years of professional experience
Work History
Customer Service Representative
Conduent
Remote
09.2024 - Current
- Resolved customer inquiries through effective communication and problem-solving techniques.
- Managed customer accounts using CRM software to ensure accurate information and service delivery.
- Assisted in training new team members on customer service protocols and best practices.
- Collaborated with cross-functional teams to enhance customer experience and streamline processes.
- Handled escalated issues with professionalism, ensuring timely resolution and customer satisfaction.
- Updated internal documentation to improve efficiency in addressing common customer concerns.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
Claims Processor Supervisor
Accenture
Remote
01.2018 - 09.2024
- Processed insurance claims accurately and efficiently, ensuring timely resolution for clients.
- Reviewed claim documentation to verify completeness and compliance with policy guidelines.
- Collaborated with cross-functional teams to streamline claims processing workflows and improve turnaround times.
- Mentored junior processors on best practices in claims handling and system navigation.
- Reviewed applications and supporting documents to verify claims eligibility and accuracy.
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Collaborated with cross-functional teams to resolve complex claims issues efficiently and effectively.
- Maintained strict confidentiality when dealing with sensitive information about patients'' medical histories or personal details.
- Identified fraudulent claims through thorough investigation and documentation of findings.
- Assisted in onboarding of new claims processors to familiarize with company procedures, policies and processes.
- Reduced claim processing time for faster customer service and improved satisfaction rates.
- Trained new team members on claims processing procedures and software systems.
- Processed and adjudicated claims with accuracy and efficiency to ensure timely resolutions.
- Reviewed documentation for compliance with regulatory standards and internal policies.
- Collaborated with cross-functional teams to resolve complex claim issues and improve workflows.
- Developed training materials to enhance knowledge of claims processing protocols among staff.
- Mentored junior processors, fostering a culture of continuous improvement and professional development.
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
Quality Control Specialist
SYSCO Food Services
Louisville, KY
04.2010 - 01.2018
- Conducted regular inspections to ensure product quality meets established safety standards.
- Developed and implemented testing protocols to enhance accuracy in product evaluations.
- Collaborated with production teams to identify and resolve quality discrepancies efficiently.
- Trained new staff on quality control procedures, fostering a culture of compliance and precision.
- Established metrics for quality assessments, ensuring alignment with industry regulations and customer expectations.
- Provided regular updates to team leadership on quality metrics by communicating consistency problems or production deficiencies.
- Reviewed technical documents such as specifications and drawings, maintaining accuracy and compliance with industry regulations.
- Recorded and organized test data for report generation and analysis.
- Collected and analyzed data to measure effectiveness of quality control processes.
- Inspected items and compared against standards to meet regulatory requirements.
Education
Associate of Science - Health Information Technology
Skills
- Customer service
- Active listening
- Critical thinking
- Data entry
- Medical Billing and Coding
- Customer relations
- Problem resolution
- Relationship building
- Call center experience
- Computer proficiency
- Conflict resolution
- Complaint handling
- Microsoft Excel
- Complaint resolution
- Client relations
- Customer satisfaction measurement
- Microsoft outlook
- Follow-up skills
- Call management
- Paperwork processing
- Product knowledge
- Documentation
- Team development
- Administrative support
- Microsoft Office Suite
- Microsoft PowerPoint
- Data collection
- Customer relationship management (CRM)
- Staff training
- De-escalation techniques
- Technical support
- Quality control
- Filing
- Dispute resolution
- Research
- Spreadsheets
- Office equipment proficiency
- [Software] CRM system proficiency
Timeline
Customer Service Representative - Conduent
09.2024 - Current
Claims Processor Supervisor - Accenture
01.2018 - 09.2024
Quality Control Specialist - SYSCO Food Services
04.2010 - 01.2018
Pinnacle Career Institute - Associate of Science, Health Information Technology