Summary
Overview
Work History
Education
Skills
Timeline
Generic

Nicole Liutermoza

Lawton,OK

Summary

Detail-oriented individual with exceptional communication and project management skills. Proven ability to handle multiple tasks effectively and efficiently in fast-paced environments. Recognized for taking proactive approach to identifying and addressing issues, with focus on optimizing processes and supporting team objectives.

Overview

15
15
years of professional experience

Work History

Utilization Management Administrator Coordinator

Humana
01.2024 - Current
  • Provide non-clinical support for polices and procedures, ensuring members receive appropriate treatment, care, and services.
  • Independently handles day-to-day tasks with minimal direction
  • Works within defined parameters to identify work exceptions and quality standards with minimal leniency over timing.
  • Follows standards and policies under state market guidelines
  • Handles claims, authorizations, and medical records with discretion
  • Works in specialty queues, ensuring that strict policy guidelines are followed.
  • Call providers/facilities to request medical records

Subject Matter Expert (SME)

WPS
08.2023 - 11.2023
  • Teach new hires how to process written inquiries, which can be new claim submissions, medical documents, reprocesses, adjustments or general information requests.
  • Assists new hires on learning their way through our systems, including how to locate benefit information, claim information, provider certification and profiles, and beneficiary profiles.
  • Developed effective training materials for diverse audiences, resulting in improved skillsets and increased job satisfaction.
    Increased consistency in employee performance by standardizing training materials across the department.
    Served as a trusted mentor to countless employees, guiding them through challenging transitions into their respective roles within the organization.
    Established strong working relationships with department managers to ensure seamless integration of new hires into established teams.
    Reduced time-to-productivity for new hires through targeted skill development and hands-on practice sessions.
    Improved overall team efficiency by identifying knowledge gaps and tailoring training materials accordingly.
  • Teach and direct new hires how to research and utilize available resources to follow the most current company policies and work instructions.
  • Support new hires in nesting while taking phone calls and learning to multitask while on calls to assist the caller to the highest standards.
  • Reviewed requests which were submitted for adjustments to verify if the information was accurate and appropriate for the request, with the proper verbiage and requested information if applicable.
  • Trained and mentored 80 new personnel hired to fulfill roles.

Customer Service Representative

WPS
01.2022 - 07.2023
  • Answer telephone calls along with e-mail inquiries, assisting providers and beneficiaries with their Tricare claims and benefits.
  • Research information using the resources provided to ensure proper Tricare/Humana Military regulations are being followed.
  • Collaborated with team members to develop best practices for consistent customer service delivery.
  • Multitasked between listening to the providers on the phone while researching and coming up with a resolution, and assisting coworkers as needed.
  • Handle on average 80-100 phone calls a day in addition to working on emails and chat.
  • Regularly exceeded performance metrics in areas such as knowledge, quality, and time.
  • Submit claims for reprocessing, adjustments, corrections, or reviews when needed.
  • Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
  • Record responses, phone calls, research and information about calls/email.
  • Handled sensitive information with discretion, ensuring confidentiality of personal and financial details throughout the claims examination process.
  • Reduced claim processing time by implementing efficient workflow strategies and prioritizing tasks effectively.
  • Enhanced customer satisfaction by promptly addressing inquiries and providing accurate information on claim status.
  • Assisted teammates when they have questions and/or when they are stuck regarding issues with claims.
  • Provided guidance and support to all new team members added to my team.
  • Boosted team morale by consistently recognizing colleagues' contributions and achievements.
  • Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
  • Maintained detailed records of all claims activities, ensuring compliance with regulatory requirements and company policies.
  • Provided coaching and mentoring to new hires, contributing to their successful integration into the team.
  • Was selected to be one of the 30 founding members of the Aspiring Leader program out of over 70 applications.
  • Weekly training and group meetings with Aspiring Leaders Program to learn skills and mindsets to prepare and teach how to become a people leader.

Technical Support Chat Representative

Startek
12.2020 - 09.2021
  • Assisted customers in navigating the website or online platform, ensuring they found the information or products they were seeking
  • Assisted customers with troubleshooting internet, phone, cable boxes, emails, signing into accounts, and security features.
  • Observed the safety protocols to ensure customer information was handled properly.
  • Multitasked between assisting numerous customers.
  • Took payments and set up automatic payments.
  • Created login accounts and reset passwords.
  • De-escalated customers who were upset and handled the problem.
  • Issued credits to accounts for outages.
  • Set up appointments for technicians to go to customers' home to resolve issues or set up new equipment.
  • Managed a high volume of chat inquiries while maintaining a professional and empathetic tone throughout interactions.
  • Maintained detailed records of each interaction to ensure accurate reporting and follow-ups when necessary.
  • Reduced waiting time for customers by consistently meeting or exceeding established response time goals.
  • Investigated and resolved customer inquiries and complaints quickly.
  • Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.

O/N Stocker Team Lead

Walmart
06.2020 - 01.2021
  • Managed the back room by organizing overstock, pulling overstock that needed to be worked, and documenting overstock.
  • Updated the quantity of items in stock in our POS.
  • Tasked team members with which product they had to work on each shift.
  • Ensured team members were on task throughout the shift.
  • Planned shelf and end caps to ensure the store was effectively marketing merchandise products depending on the season and local events happening.
  • Tracked team member work to ensure nightly goals were being met.
  • Ensure that department goals were being met every shift, monthly goals as well as quarterly goals.
  • Unloaded, sorted, and stocked merchandise according to store layout and product placement.
  • Updated pricing by changing labels and signage for short-term promotions and final clearances.
  • Boosted employee morale through recognition programs and fostering a supportive work environment.
  • Completed end-of-day tasks such as returning misplaced items to their correct locations, contributing to an organized sales floor for the next day's business.
  • Ensured proper rotation of perishable goods to maintain freshness and comply with health regulations.
  • Interacted with guests in a friendly and knowledgeable way.
  • Streamlined restocking processes by consolidating backstock and removing damaged or expired items.
  • Aided in training new team members on best practices for stocking procedures and inventory management systems.
  • Maintained tidy and clean work areas to promote optimal productivity and safety standards.
  • Moved pallets to and from trucks and around the warehouse with forklifts to stay on top of demanding schedules.

O/N Stocker

Walmart
10.2019 - 06.2020
  • Assisted the customers by finding items quickly, helping store, and customer satisfaction.
  • Certified in electric pallet jack.
  • Observed the safety protocols when transporting merchandise to different areas of the store to alleviate item damage.
  • Multitasked between assisting numerous customers finding products they need.
  • Used pallet jacks to move pallets to staging areas.
  • Unboxed product and placed on shelves according to layout guidelines.
  • Realigned merchandise throughout the assigned section to give shelves a professional appeal.
  • Collected assigned merchandise and transported to store floor locations using pallet jacks.
  • Adhered to safety processes and procedures when stocking to avoid falls and other injuries.
  • Performed light housekeeping and cleaning by discarding trash and cardboard and sweeping floors.
  • Checked aisles and action areas for spills or safety issues handled clean-up or notified custodians.
  • Kept aisles neat and clean while restocking to prevent accidents and enable others to pass by quickly.
  • Maintained current knowledge of shelf and end cap plans to effectively merchandise products.

Nanny & SAHM

Home
12.2013 - 10.2019
  • Work as a stay at home mother to two kids while husband served in the United States Marine Corps.
  • Assumed all primary caregiver duties.
  • Activities of daily living, including getting children to school, and extra curriculum activities after school.
  • Maintained a neat and orderly house, including daily household chores, laundry, paying bills, and maintaining, organizing schedules preparing and servicing all meals and snacks.
  • Entertainment and educational stimulation.
  • Constructed challenging and intriguing educational curriculums.
  • Performed the single instruction of learning to read.
  • Volunteered at preschool, classroom helper, occasional transportation for a dog shelter.

Customer Service Lead/Key Holder

Toys R Us
04.2013 - 11.2013
  • Handle problems with customers, such as items not being in stock or price adjustments.
  • Assisted customers with any returns or exchanges, they had as well as purchases. I also signed customers up for store rewards and credit cards.
  • Helped customers order products that we did not have in store.
  • Organized the front end, cleaned restrooms and around the store as needed.
  • Turned keys for returns and exchanges as other employees needed.
  • I trained any new associates in proper front end procedures such as what is required and how to sign customers up for loyalty programs.
  • I trained new associates on how to operate the register and computer systems to help with orders, look up members, apply coupons.

USMC
09.2011 - 04.2012
  • Twelve weeks of basic training, Rifle Marksman, 300 PFT score, learned and developed the 14 leadership traits and continue to execute them daily.

Customer Service

Bed Bath & Beyond
08.2010 - 09.2011
  • Maintained current knowledge of store promotions and highlighted sales to customers.
  • I assisted customers with setting appointments, shipping, and special-order requests and arranging merchandise pick-up at other locations.
  • Restocked, arranged, and organized merchandise in front lanes to drive product sales.
  • I assisted customers with locating and choosing merchandise in any store department.
  • Answered questions about store policies and concerns to support positive customer experiences.
  • I processed POS transactions, including checks, cash, and credit purchases or refunds.
  • I maintained customer satisfaction while handling product returns quickly and professionally.
  • I used POS system to enter orders, process payments, and issue receipts.

Education

Criminal Justice

UNIVERSITY OF MARYLAND UNIVERSITY COLLEGE
01.2018

High School Diploma -

NORTHWESTERN REGIONAL #7
05.2011

Skills

  • Composed
  • Adaptivity
  • Excellent verbal and written communication skills
  • Proficient in Microsoft Office including Word, PowerPoint, and Excel
  • Excellent attention to detail
  • Ability to multitask
  • Organization and time management
  • Prioritization
  • Communication
  • Strategic thinking
  • Reliability
  • Overcoming challenges
  • Team coordination
  • Document management
  • Conflict resolution
  • Coaching and mentoring

Timeline

Utilization Management Administrator Coordinator

Humana
01.2024 - Current

Subject Matter Expert (SME)

WPS
08.2023 - 11.2023

Customer Service Representative

WPS
01.2022 - 07.2023

Technical Support Chat Representative

Startek
12.2020 - 09.2021

O/N Stocker Team Lead

Walmart
06.2020 - 01.2021

O/N Stocker

Walmart
10.2019 - 06.2020

Nanny & SAHM

Home
12.2013 - 10.2019

Customer Service Lead/Key Holder

Toys R Us
04.2013 - 11.2013

USMC
09.2011 - 04.2012

Customer Service

Bed Bath & Beyond
08.2010 - 09.2011

High School Diploma -

NORTHWESTERN REGIONAL #7

Criminal Justice

UNIVERSITY OF MARYLAND UNIVERSITY COLLEGE

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