Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Rolanda Royal

Marietta,GA

Summary

Dynamic leader with a proven track record at UnitedHealthcare, adept in benefits analysis and fostering team collaboration. Excelled in enhancing service delivery through data analytics and problem-solving, achieving significant improvements in customer satisfaction. Skilled in policy interpretation and healthcare regulations, my advocacy expertise and customer focus drive operational excellence and compliance.

Overview

19
19
years of professional experience
1
1
Certification

Work History

Member Service Advocate

UnitedHealthcare
10.2024 - Current
  • Handled sensitive member information responsibly, adhering strictly to privacy regulations and guidelines.
  • Resolved escalated member issues with diplomacy, tactfully navigating challenging situations while maintaining rapport with the customer.
  • Utilized data analysis to identify trends in customer feedback, driving continuous improvement efforts within the team.
  • Participated in regular training sessions to stay current with industry trends and enhance knowledge base.
  • Listen actively and ask appropriate questions in order to identify specific questions or issues, and document inquiries from members of UHC’s programs regarding the following:
  • Medical, vision, dental, pharmacy, HSA, FSA plan details and reviews
  • Plan / program eligibility
  • Medical Claims Review and Process/CPT Codes Review
  • Use multiple databases, tools, and partnerships to refer and enroll members to appropriate internal specialists and programs, based on needs
  • Interpret and translate clinical / medical terminology and coding to assist members with managing cost using simple language
  • Adapt to communicated changes in process, policy, and guidelines quickly at site and enterprise level
  • Educate members about the fundamentals of health care benefits and plans
  • Assist members to maximize use of community services, support programs, and resources available

Senior Customer Service Success Team Lead

Optum
10.2012 - 10.2024
  • Trained new team members by relaying information on company procedures and safety requirements.

● Identify trends in the support calls and develop guidance to address recurring issues and inquiries. Completed Monthly/Quarterly Reporting to varies Account Managers

  • Collaborated with other department leads to streamline workflows, improve interdepartmental coordination, and achieve business goals collectively.
  • Promoted a positive work environment by fostering teamwork, open communication, and employee recognition initiatives.
  • Worked different stations to provide optimal coverage and meet production goals.
  • Evaluated employee skills and knowledge regularly, training, and mentoring individuals with lagging skills.
  • Increased customer satisfaction by ensuring timely completion of projects and adherence to high-quality standards.
  • Served as a role model for the team by demonstrating commitment to excellence, professionalism, and adherence to company values at all times.
  • Influenced positive change within the organization through strategic thinking, innovation, problem-solving abilities, and consistent leadership style.
  • Managed risks and mitigated potential issues through proactive planning, monitoring, and timely decision making.
  • Coached team members in techniques necessary to complete job tasks.
  • Educated staff on organizational mission and goals to help employees achieve success.

● Cross-Functional Collaboration Working closely with sales, marketing, and product teams, I have effectively communicated customer needs and advocated for product improvements to meet market demands

  • Collected, arranged, and input information into database system.

● Customer Onboarding/Training: led customers onboarding processes, ensuring smooth implementation and empowering clients to maximize the value of their investment

  • Conducted regular reviews of operations and identified areas for improvement.

● Own and manage multiple shared group mailboxes supporting members’ product

  • Created and managed project plans, timelines and budgets.

portal.

● Team Leadership nurtured a positive and collaborative environment to motivate my team to excel as a resource for other team members; provide training, support and technical guidance to new hires and peers encompassed with scheduling and workload management.

● Implement programs reviewing the functionality of URLs and processes for the

various programs.

Career Educational Benefits Advisor

Dept Of Defense (Contract)
06.2009 - 10.2012
  • Directed and controlled 401K, medical, dental, and vision benefit packages.
  • Streamlined claims processing, accelerating resolution times and improving employee experience.
  • Collaborated with HR team to create and implement wellness programs that improved employee health and productivity.
  • Partnered with mental health providers to add comprehensive mental health support to benefits packages.
  • Delivered informative presentations on benefits options, ensuring employees were well-informed and could make educated decisions.
  • Established metrics for evaluating benefits program effectiveness, leading to data-driven enhancements.
  • Assessed the effectiveness of current benefit offerings through regular employee surveys, using feedback to inform future program enhancements.
  • Championed diversity and inclusion by incorporating range of benefits suitable for diverse workforce.
  • Collaborated with HR teams to integrate benefits administration with broader HR systems, enhancing operational efficiency.
  • Streamlined benefits enrollment process for new hires, ensuring a smooth onboarding experience.
  • Conducted detailed benefits analysis to tailor plans that met employee needs and company budget constraints.
  • Partnered with HR leadership to review and update benefits-related policies and procedures, ensuring legal compliance and best practices.
  • Leveraged data analysis skills to monitor usage patterns within various benefit programs, identifying areas for potential improvement or cost savings.
  • Implemented digital benefits platform, enhancing accessibility and engagement among workforce.
  • Enhanced employee satisfaction by effectively addressing benefit inquiries and providing timely resolutions.
  • Facilitated seamless transitions during mergers or acquisitions by coordinating efforts between multiple departments and benefit providers.

Senior Financial Aid Counselor | TitleIV

ORLEANS TECHNICAL INT.
07.2007 - 06.2009
  • Maintained comprehensive knowledge of industry trends and regulatory updates, ensuring all staff members received timely training on relevant changes impacting student funding options.
  • Streamlined office operations by developing efficient policies and procedures that reduced wait times during peak periods significantly.
  • Managed a caseload of over 300 students, ensuring efficient processing of financial aid applications and disbursements.
  • Developed comprehensive training materials for new staff members, resulting in more consistent service delivery.
  • Built strong relationships with students and their families, providing compassionate support and guidance throughout the financial aid application process.
  • Implemented effective communication strategies to keep students informed about deadlines and important updates related to their financial aid status.
  • Assisted families in understanding their individualized financial aid packages, leading to informed decision-making regarding enrollment choices.
  • Reduced processing errors by implementing systematic reviews of student files for accuracy and completeness.
  • Led efforts to establish a centralized database of scholarship opportunities accessible to all students seeking additional funding sources beyond traditional loans and grants programs.
  • Evaluated eligibility criteria for various scholarship programs, recommending qualified candidates based on academic performance, need, or other qualifying factors.
  • Provided expert guidance on navigating complex federal regulations, ensuring compliance with all statutory requirements related to student funding programs.
  • Conducted informative financial aid workshops for prospective students, increasing awareness of available resources and support services.
  • Collaborated with fellow counselors to implement best practices in financial aid counseling and case management.
  • Increased student retention rates by proactively identifying at-risk students and providing targeted financial assistance options.
  • Served as the primary liaison between the Financial Aid Office and other campus departments, fostering strong working relationships for improved collaboration.
  • Advocated for students facing unique circumstances or hardships, securing additional funds through appeals processes when necessary.
  • Reviewed initial financial aid applications for accuracy and compliance with reporting standards.
  • Designed financial aid reward packages, aligning contents with individuals' monetary and logistical needs.
  • Reviewed financial aid appeals, issuing secondary and final judgments on award packages.
  • Processed loan applications and monitored progress from start to finish.
  • Monitored pipelines to track and log status of loans.

Financial Aid Officer

University of Phoenix
09.2005 - 06.2007
  • Reviewed initial financial aid applications for accuracy and compliance with reporting standards.
  • Counseled students and parents about financial aid options and program details.
  • Provided financial aid counseling to enrolled and prospective students.
  • Authored presentations and documentation for distribution to current and prospective students.
  • Communicated with prospective students to illustrate available financial aid opportunities.
  • Designed financial aid reward packages, aligning contents with individuals' monetary and logistical needs.
  • Represented financial aid office at group meetings with high school students and parents.
  • Processed unique financial aid profiles for undergrad and post-grad applications.
  • Collaborated with community-based organizations to increase economic diversity of applicant pools.
  • Proactively identified potential barriers to enrollment or retention, developing solutions to address these challenges for at-risk populations.
  • Conducted regular evaluations of policies and procedures, recommending improvements based on best practices within the industry.
  • Improved student satisfaction with financial aid services by providing timely and accurate information on available resources.
  • Managed a caseload of over 500 students, ensuring individualized attention and prompt resolution of issues.
  • Evaluated the effectiveness of institutional aid policies, adjusting strategies as needed to ensure equitable distribution of resources among students from diverse backgrounds.
  • Assisted students in navigating complex loan repayment options, resulting in lower default rates for the institution.
  • Complied with state and federal financial aid guidelines and regulations.
  • Monitored institutional budgets, allocating funds effectively to maximize available assistance for students in need.
  • Advised students in making academic decisions and financial management.
  • Collaborated with academic departments to develop targeted financial aid packages for students in specific majors or programs.
  • Provided comprehensive training to new staff members, ensuring consistent delivery of high-quality service to students and their families.
  • Organized financial literacy workshops for students and their families, empowering them to make informed decisions about college costs and loan repayment options.
  • Participated in regional conferences, staying current on emerging trends within higher education financing to better serve our student population.

Education

Bachelor of Science - Social Work/Human Services

Southern University At New Orleans
New Orleans, LA
06-2008

Skills

  • Benefits analysis
  • Data analytics
  • Microsoft office
  • Documentation and reporting
  • Policy interpretation
  • Government relations
  • Social services
  • Medicaid
  • Insurance verification
  • Healthcare regulations
  • Claim adjustments
  • Medical record review
  • Insurance claims processing
  • HIPAA
  • Insurance claims
  • Healthcare billing
  • ICD codes
  • Electronic claims processing
  • Insurance claims management
  • Claims investigation
  • Prior authorization processing
  • Insurance claim forms review

Certification

  • Microsoft Office Specialist (MOS) - Microsoft.
  • First Aid Certification


Timeline

Member Service Advocate

UnitedHealthcare
10.2024 - Current

Senior Customer Service Success Team Lead

Optum
10.2012 - 10.2024

Career Educational Benefits Advisor

Dept Of Defense (Contract)
06.2009 - 10.2012

Senior Financial Aid Counselor | TitleIV

ORLEANS TECHNICAL INT.
07.2007 - 06.2009

Financial Aid Officer

University of Phoenix
09.2005 - 06.2007

Bachelor of Science - Social Work/Human Services

Southern University At New Orleans
Rolanda Royal