Michael A. Jones
Jacksonville,Fl
Summary
With over 15 years of leadership experience. I consistently achieved top performance in servicing the company’s and the customers’ needs. I coordinated activities with a wide variety of individuals and promoted the collaboration of teams to achieve goals. I am motivated by challenge and growth. This, combined with my skills and experience, will enable me to be an exceptional Team Member and provide the quality and service necessary for the department’s continued success.
Key Attributes
People Management: Building relationships and effectively delivering ideas, instructions, and information through clear and concise written and verbal communications. Promotes and encourages individual and team accountability.
Leadership: Demonstrating accountability, integrity, and influence. Making good decisions aligned with the company's vision, mission, goals, and values.
Change Agent: Ability and willingness to learn, adaptability to new technologies, flexibility when situations change, and ability to work in an ambiguous environment.
Exceptional organizational skills and effectively meet negotiated timeframes, commitments, resources, and deliverables related to project leadership/participation and operational improvement support.
Coordinate departmental staffing and scheduling needs with supervisors and managers, including all training, meetings, and miscellaneous events that could affect service levels.
Produce and review reports; recommend productivity and efficiency improvements. Perform quality monitoring sessions for online representatives and provide feedback for their development.
Served as a Subject Matter Expert (SME) for training classes of up to 30 Representatives. Resolve customer escalations in a supervisor capacity promptly.
Provided performance trends and analysis to team members and administered corrective actions.
Overview
25
25
years of professional experience
Work History
Forecasting & Analyst 1
COMCAST
Jacksonville, FL
02.2012 - Current
- Forecasting & Analyst serve as an initial contact point for all scheduling issues: assist with modifying existing agent schedules to meet call center objectives
- Functions as a liaison with other organizational areas/departments to resolve call center personnel issues relating to staffing, payroll, capacity, day-off requests, and other system updates
- Determine workforce requirements to meet service level and response time objectives
- Participating in a prestigious Future Leader Program, focusing on leadership and team development
- Great Place to Work Ambassador promoting team engagement through strategic and international activities
- Provide daily phone and function support by monitoring callouts and other flexible scheduling options
- Strong organizational and time management skills allowed me to adhere to strict time constraints
- Cross-trained and worked on multiple platforms simultaneously
- Selected on several occasions by upper management for offline projects
- Subject matter expert in payroll approvals, vacation bids, time off approvals, and daily schedule processes
- Creates policies and procedures to standardize specific WFM functions
- Provides support, mentorship, and feedback to team members about WFM best practices.
Claims Examiner Supervisor
SOURCE INTERNATIONAL, THE CSI COMPANIES
Orange Park, FL
10.2011 - 02.2012
- To analyze, prepare, record, and reconcile warranty claims and submit them to the factories
- Verifies criteria required by factory or distributor
- Follows up with the factory and distributors regarding unpaid claims and ongoing adjudication of claims
- Supported call center leaders in daily functions, including attendance tracking, agent availability, scheduled adherence, and high-dollar adjustments
- Analyzes and processes complex or technically challenging claims by investigating and gathering information for an appropriate and timely resolution
- Calculates and pays benefits due; approves and makes timely claim payments and adjustments
- Planning and implementation of effective agent scheduling to ensure contractual service level and budget goals are achieved.
Reconciliation Team Lead / Financial Recovery Team Lead
HUMANA
Jacksonville, FL
11.2007 - 09.2011
- Reconciliation Unit is a dedicated service unit that facilitates the administration of provider service agreements which set forth the rights and responsibilities for both Humana and the provider
- Work closely with other areas within Humana, other hospitals, and faculties to ensure the resolution of problems and customer satisfaction
- Maintain provider Reconciliation report of less than 15% for claims over 60 days old
- Complete the monthly reconciliation spreadsheet within 21 days
- Claim payment resolution (Payment disputes, incorrect denials, Underpayments, and Overpayments)
- Appeals and Reconsideration for Medical Review (Medical Necessity)
Customer Service Retention Team Lead
ADT SECURITY SERVICE
Jacksonville, FL
02.2006 - 11.2007
- The responsibility of the Retention Specialist is to retain ADT residential customers via inbound/outbound phone calls and correspondence
- A retention Specialist is a Subject Matter Expert in Account Services, Retention Offers & Promotions
- Accountable for following up on retention efforts via database entries, MAStermind Actions, and contacts to ensure the resolution of problems and customer satisfaction
- Work closely with Service/Sales Managers for customer retention resolutions.
Credit/Adjustment Specialist
BLUE CROSS BLUE SHIELD OF FLA
Jacksonville, FL
08.2003 - 01.2006
- Credit/Adjustment Specialist collects and processes data while directly responding to questions, resolving concerns, and providing guidance on transactions, inquiries, and complaints from both internal and external customers while responding to other BCBS plans throughout the nation to ensure that all claims have been processed and have been paid correctly
- Identify and report inconsistencies relative to the adjudication of claims for contract compliance and communicate issues and resolutions to supervisors and operational units
- Analyze errors to determine their root cause and promptly develop solutions to meet business objectives
- Set up claims for Re-Entry and or reprocessing for payment or recoup funds.
Customer Care Team Lead/Supervisor
T-MOBILE
Jacksonville, FL
10.1998 - 07.2003
- Customer Service Team Leads are mentors, helping their team members improve and exceed even their expectations on the job
- Interpersonal skills are significant in educating and motivating a team of approximately 15 representatives excellent time management and multi-tasking skills
- Supported call center supervisors and managers in daily functions
- Resolved customer escalations in a supervisor capacity promptly
- Provided performance trends and analysis to team members.
Education
BS - Political Science and Government, Computer Information Continued… Continued… Continued
The University of Arizona Global Campus
Timeline
Forecasting & Analyst 1
COMCAST
02.2012 - Current
Claims Examiner Supervisor
SOURCE INTERNATIONAL, THE CSI COMPANIES
10.2011 - 02.2012
Reconciliation Team Lead / Financial Recovery Team Lead
HUMANA
11.2007 - 09.2011
Customer Service Retention Team Lead
ADT SECURITY SERVICE
02.2006 - 11.2007
Credit/Adjustment Specialist
BLUE CROSS BLUE SHIELD OF FLA
08.2003 - 01.2006
Customer Care Team Lead/Supervisor
T-MOBILE
10.1998 - 07.2003
BS - Political Science and Government, Computer Information Continued… Continued… Continued
The University of Arizona Global Campus