Summary
Overview
Work History
Education
Skills
Timeline
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Rolanda Royal

Marietta,GA

Summary

Dynamic team leader with extensive experience in customer service and regulatory compliance. Known for exceptional conflict resolution skills and ability to streamline processes, contributing to improved operational performance.

Overview

17
17
years of professional experience

Work History

Escalation Team Lead

United Healthcare Group
Atlanta, GA
10.2019 - Current

Resolved escalated customer complaints or queries promptly and efficiently.

  • Led team meetings to discuss project updates and address concerns.
  • Coordinated workflow among departments to enhance collaboration and efficiency.
  • Billing: Medical, Pharmacy, and DME Claims; Eligibility Resolution Issues.
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
  • Identified needs of customers promptly and efficiently.
  • Developed training materials to support employee onboarding and development.
  • Facilitated communication between management and team members for clarity.
  • Exceeded customer satisfaction by finding creative solutions to problems.
  • Utilized advanced technical skills and expertise to troubleshoot complex problems and implement solutions.
  • Utilized various software and tools to streamline processes and optimize performance.

Senior Customer Service Success Team Lead

OptumHealth
Atlanta, Georgia
10.2012 - 05.2019
  • Coordinated daily operations to ensure efficient service delivery to clients.
  • Developed training materials for new hires and existing staff on healthcare protocols.
  • Oversaw compliance with regulatory requirements and quality standards in healthcare services.
  • Consulted clients to assess insurance needs and recommend appropriate coverage options.
  • Developed and maintained strong relationships with insurance carriers and underwriters.
  • Collaborated closely with sales teams on new customer on-boarding process ensuring proper credit policies are followed at all times.
  • Coordinated cross-functional teams across multiple departments during the customer onboarding process.
  • Provided technical support during customer onboarding processes.

Career Educational Benefits Advisor

Dept Of Defense
Blue Bell, Pennsylvania
04.2009 - 09.2012
  • Advised clients on benefits options and eligibility requirements.
  • Conducted benefit enrollment sessions for new employees and existing staff.
  • Assisted in resolving employee inquiries regarding health plans and retirement benefits.
  • Organized workshops to educate employees about available benefits programs.
  • Reviewed and updated benefits materials to ensure compliance with regulations.
  • Maintained accurate records of employee benefit selections and changes.
  • Researched new products and services available from providers to ensure the best value for the company's benefit offerings.
  • Participated in open enrollment meetings with employees to answer questions about benefits options offered by the company.
  • Generated invoices related to the organization's benefit programs based on usage data provided by vendors.
  • Assessed requests for special accommodations due to medical conditions or disabilities when determining eligibility for certain benefits.
  • Compiled data from multiple sources into concise reports suitable for management review.
  • Processed claims filed by employees under the organization's group health plan according to established policies and procedures.
  • Resolved customer service inquiries concerning various types of insurance coverage, policy changes, premiums.

Education

Bachelor of Science - Human Services Management

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

Skills

  • Customer service
  • Team leadership
  • Regulatory compliance
  • Technical support
  • Workflow coordination
  • Client relationship management
  • Project management
  • Benefits administration
  • Process optimization
  • Effective communication
  • Conflict resolution
  • Performance monitoring
  • Complaint resolution
  • Insurance coordination
  • Claims processing
  • Customer relationship management
  • Dispute tracking
  • Claims history analysis
  • Proficient in Salesforce; Jira; Epic; Medical/Pharmacy Claims; One Note; Microsoft 365;

Timeline

Escalation Team Lead

United Healthcare Group
10.2019 - Current

Senior Customer Service Success Team Lead

OptumHealth
10.2012 - 05.2019

Career Educational Benefits Advisor

Dept Of Defense
04.2009 - 09.2012

Bachelor of Science - Human Services Management

Southern University At New Orleans
Rolanda Royal