Nina D. Hughes
Saint Louis,MT
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Experienced Representative with over 20 years of experience in customer services. Expanded skills working as a Trainer, Call Center Supervisor and Quality Assurance Coordinator. Currently I have been an Appeals and Grievance Coordinator for 5 years. I am seeking a full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
30
30
years of professional experience
Work History
GRIEVANCE COORDINATOR
Evolent, Appeals
12.2020 - 10.2025
CUSTOMER CARE ASSOCIATE 2 EVOLENT
Evolent, Appeals
05.2016 - 12.2020
CUSTOMER CARE ASSOCIATE
Evolent
01.2015 - 04.2016
SALES/CUSTOMER SERVICE
Charter Communications
10.2013 - 04.2015
- . Customer Service support for sales, billing questions and inquiries.
- . Help new customers set up Cable, Internet, and Phone services.
- . Process service Approval request.
- . Accept pre-payment and payments.
- . Map quest addresses to ensure address is in the Charter footprint.
- . Support for customers requesting store locations and offices.
Bank of America
10.2013 - 03.2015
- October 2013-March 2015
- . Customer Service Collections.
- . Educate Customers on Mortgage loans and Foreclosures.
- . Process loan payments.
- . Assist homeowners in getting delinquent loan help.
- . Taking financial data needed to qualify for loan modifications.
CUSTOMER SERVICE SUPERVISOR
Macy's Credit and Customer Service
11.1995 - 07.2012
- . Worked with a dedicated team of 20 sales associates.
- . Recruiting, developing/training, coaching, motivating, retaining, and evaluating staff.
- . Ensured service goals are achieved while maintaining service levels.
- . Maintain talk/wrap time, service data to ensure customer and client satisfaction levels.
- . Provide extensive support to agents including coaching and educating.
- . Quickly and effectively solve customer challenges.
- . Maintain quality control/satisfaction records, constantly seeking new ways to improve customer service.
- . Handle escalation issues in a timely professional manner.
- Trainer Macy's Credit and Customer Service.
- . Facilitate classes.
- . Provide and create learning materials.
- . Design and conduct classroom and web-based training for the company.
- . Served as the sole designated trainer for one of the company's largest projects: Backline.
- . Created all step-by step training documents for Web Ex, Power Point and Snap to capture screen shots.
- Backline Supervisor Macy's Credit and Customer Service.
- . Ensured catalogs were loaded into the system for Macy's and Bloomingdales.
- . Prepared reports and performed sales analysis.
- . Helped organize Bloomingdales events.
Skills
- Successful at managing high caseloads in fast-paced Environments
- Excellent planning and problem-solving abilities
- Knowledgeable of state / federal guidelines & company polices
- Managed timely queue check Professional writing & presentation skills
- Ability to deep dive complex issues Responsible for validating expedited cases in a timely fashion
- Responsible for calls and emails
- Check tools and resources, notes for proper call handling
- Queue Management
- Responsible for checking appeal dates, acknowledgement letters
- Identify expedited cases and route properly- call out team or nurses
- Process PARRS and Overturns for assigned Health Plans
- Attach faxes to incoming Appeals cases
- Cenpas Claim processing
- Research procedure codes for possible Approved cases
- Create and send back assigned cases to the health plan
- Time management skills to make sure all work is completed
Timeline
GRIEVANCE COORDINATOR
Evolent, Appeals
12.2020 - 10.2025
CUSTOMER CARE ASSOCIATE 2 EVOLENT
Evolent, Appeals
05.2016 - 12.2020
CUSTOMER CARE ASSOCIATE
Evolent
01.2015 - 04.2016
SALES/CUSTOMER SERVICE
Charter Communications
10.2013 - 04.2015
Bank of America
10.2013 - 03.2015
CUSTOMER SERVICE SUPERVISOR
Macy's Credit and Customer Service
11.1995 - 07.2012