Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

Monique Newsome

Atlanta,GA

Summary

To obtain a position that will utilize my extensive customer care, business and communication skills.

Dedicated and self-motivated individual offering a 10-year background in the customer service Industry and recruitment. Excellent oral, communication and multi-tasking skills. Works well both independently and as a contributing member of the team. Consistently awarded additional responsibilities, with a proven record of achievement in meeting and exceeding customer and employer expectations. Committed to provide exceptional client service. Proficient in Microsoft Office and internal software applications. Creative problem-solving ability. Ability to recognize and identify solutions. Able to follow, critically evaluate, and improve upon current processes. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Qualified Claims Representative versed in investigating claims, verifying information and managing settlements. Friendly and upbeat team player with organized and disciplined approach.

Overview

20
20
years of professional experience

Work History

Senior Supports Broker/NJ DDD Enrollment Specialist

PPL Public Partnerships
02.2018 - Current
  • Identifies community resource services and supports to participants and families, conducts home visits to participants and provides quarterly and initial enrollment visits, assists service providers and direct care workers, maintains progress notes in accordance with NASW standards, report and respond to participant complaints and grievances, acts as a mandated reporter for allegations of abuse, neglect and exploitation.
  • Managed time efficiently in order to complete all tasks within deadlines
  • Organized and detail-oriented with strong work ethic
  • Used critical thinking to break down problems, evaluate solutions and make decisions
  • Identified issues, analyzed information and provided solutions to problems

Claims Representative I

Elevance Health (BCBS)
10.2021 - 12.2022
  • Codes and processes claims for payment ensuring all information is supplied before eligible payments are made and researches and analyzes claims issues.
  • Analyzed and addressed escalated claims to resolve issues quickly
  • Calculated adjustments, premiums and refunds
  • Researched and analyzed complex claims to determine next steps and possible outcomes

Senior Benefits Administrator Supervisor (Call Center)

Conduent (Formerly Xerox)
08.2011 - 02.2018
  • Answered inbound calls from employees and employers, performed transactional duties in relation to Administering medical, dental, group life insurance, 401K and flexible spending accounts
  • Experienced in AIS PASS, HRIS, HCM, provided human resources management support to clients, assisted with payroll and time keeping services such as People Soft and Workday
  • Knowledgeable of the Affordable Care Act (ACA), COBRA LTD, STD
  • Provided follow up on various inquiries and client escalations
  • Managed a team of 23+ Customer Care representatives.
  • Provided New Hire and onboarding training, assisted with monthly quality assurance monitoring and reporting
  • Conducted Annual enrollment interviews
  • Attended required weekly calibration calls with the client.
  • Reviewed benefits paperwork for accuracy and completeness
  • Managed employee benefits program, working with vendors, providers and staff to maintain strong portfolio of insurance and retirement options
  • Managed continuous enrollment processes, as well as yearly enrollment periods
  • Directed and controlled 401K, medical, dental, and vision benefit packages
  • Demonstrated respect, friendliness and willingness to help wherever needed
  • Adaptable and proficient in learning new concepts quickly and efficiently
  • Used critical thinking to break down problems, evaluate solutions and make decisions
  • Identified issues, analyzed information and provided solutions to problems
  • Developed and maintained courteous and effective working relationships

Senior Collections Representative

ARM
09.2009 - 07.2011
  • Overseen collection investigations, analysis and follow up for the collection of overdue accounts, made payment arrangements and wrote payment plans, advised clients of alternative solutions for meeting their obligations, provided assistance in resolving difficult collection cases, developed.
  • Delivered exceptional customer service on collection calls and maintained calm and professional demeanor
  • Worked in call center environment handling manual and automatically dialed outbound calls
  • Achieved performance goals on consistent basis
  • Maintained high volume of calls and met demands of busy and productive group
  • Resolved customer disputes and disagreements through professional, calm communication to find mutually beneficial solutions
  • Collected on delinquent accounts to reduce overdue balances
  • Identified and contacted customers with overdue accounts to address payment status
  • Developed strong relationships with customers to foster timely payments and account resolution
  • Responded to customer inquiries and provided detailed account information
  • Maintained accurate records of customer accounts, payments and payment plans

Lilly Lecture Bureau Coordinator

Knowledge Point 360 Group (Eli Lilly and Company)
09.2007 - 05.2009
  • Processed honorarium and expense checks for physicians, navigated Lilly employees and district managers through the company intranet, arranged travel arrangements for physicians and field representatives, confirmed meetings via email, telephone and regular mail
  • Responsible for filing programs in chronological order and assisted in audits.
  • Built relationships with customers and community to establish long-term business growth
  • Developed compelling presentation decks to gain approval for ideas and communicate results

Quality Assurance Manager

Auto Action Group
07.2003 - 08.2008
  • Responsible for 100+ call audits per month, assisted with all aspects of administrative management, conducted new hire orientation, conducted open enrollment training for employees, responsible for adding requested call audits to the LAN
  • Performed root cause analysis to identify and resolve quality issues and defects
  • Implemented new quality assurance and customer service standards
  • Monitored staff organization and suggested improvements to daily functionality

Education

A.S. Social Sciences -

Essex County College
Newark, NJ

A.S. Criminal Justice -

Gibbs College
Livingston, NJ

Skills

  • Financial Analysis
  • Compliance Requirements
  • Risk Mitigation
  • Compliance Adherence
  • Critical Thinking
  • Self-Directed
  • MS Office
  • Team building
  • Remote Office Availability
  • Analytical Thinking
  • Multitasking Abilities
  • Attention to Detail
  • Organization and Time Management
  • Time Management

Accomplishments

  • Supervised team of 25 staff members.
  • Documented and resolved numerous concerns which led to positive results.

Timeline

Claims Representative I

Elevance Health (BCBS)
10.2021 - 12.2022

Senior Supports Broker/NJ DDD Enrollment Specialist

PPL Public Partnerships
02.2018 - Current

Senior Benefits Administrator Supervisor (Call Center)

Conduent (Formerly Xerox)
08.2011 - 02.2018

Senior Collections Representative

ARM
09.2009 - 07.2011

Lilly Lecture Bureau Coordinator

Knowledge Point 360 Group (Eli Lilly and Company)
09.2007 - 05.2009

Quality Assurance Manager

Auto Action Group
07.2003 - 08.2008

A.S. Social Sciences -

Essex County College

A.S. Criminal Justice -

Gibbs College
Monique Newsome