Mercedes Graham

• Analyzed complaint data to identify root causes, trends, issues and regulatory concerns.
• Conducted quality control reviews on complaint data and addressed results with colleagues to influence positive change.
• Trained new team members in proper complaint handling procedures, fostering a consistent approach across the organization.
• Maintained up-to-date knowledge of product and service changes.
• Responded proactively and positively to rapid change.

Provider service Representative - Remote 2018 - 2021

• Promoted within 3 years of the company for exceeding goals and outstanding performance on assigned projects.
• Coordinated with internal departments on behalf of providers to ensure timely payment resolution for claims disputes or other financial matters.
• Cross-trained and backed up other customer service managers.
• Trained new personnel regarding company operations, policies and services.

• Delivered exceptional customer service experiences by maintaining a positive attitude, active listening skills, and empathetic responses to customer concerns.
• Provided timely assistance to customers via phone, email, and live chat channels, ensuring high level of professionalism at all times.
• Handled escalated support cases with diplomacy and tact, successfully defusing tense situations between company and its customers.
• Maintained thorough knowledge of product offerings to provide accurate information and expert advice to customers.
• Participated in regular meetings with management to discuss ongoing departmental challenges and propose actionable solutions.

• Researched and resolved billing discrepancies to enable accurate billing.
• Updated, entered, and reviewed customer data.
• Monitored financial transactions to ensure accurate billing processes were followed consistently.
• Communicated effectively via telephone, email, and in person with prospective customers.
• Resolved financial discrepancies and customer billing issues with timely attention.
• Served as liaison between members, providers, and health plan for seamless communication during enrollment process.