SANDRA J. WILSON
Nebo,NC
Summary
Dynamic Complaint Resolution Coordinator at the Medical Review Institute of America, adept at enhancing operational efficiency through process improvement and effective communication. Proven track record in regulatory compliance and conflict resolution, successfully streamlining workflows and training staff to elevate customer satisfaction and drive performance.
Overview
21
21
years of professional experience
Work History
Complaint Resolution Coordinator
Medical Review Institute of America
Salt Lake City, Utah
07.2023 - Current
- Coordinated resolution processes for medical review cases and claims inquiries.
- Collaborated with healthcare professionals to clarify case details and requirements.
- Managed documentation and communication between parties involved in reviews.
- Analyzed case files to ensure compliance with regulatory standards and procedures.
- Facilitated training sessions for staff on resolution protocols and best practices.
- Maintained accurate records of case resolutions and client interactions.
- Developed strategies to streamline resolution workflows and improve efficiency.
- Provided support to team members in complex case analysis and decision-making processes.
- Provided insights into the effectiveness of current processes used for addressing complaints from customers.
- Collaborated with cross-functional teams to develop strategies that addressed customer concerns and improved operational efficiency.
- Identified any potential risks associated with resolving customer issues before making final decisions.
- Coordinated the resolution process between customers, management team, field staff, vendors, suppliers.
- Analyzed reports from various departments such as sales, finance, marketing, to assess overall performance against goals set out by the organization.
- Assisted in developing training materials for new employees on how best to resolve customer complaints efficiently.
- Drafted written responses to customer inquiries in a timely manner while following established guidelines.
- Reviewed existing processes for resolving customer issues and proposed changes where necessary.
- Utilized problem solving skills when dealing with challenging situations or difficult customers.
- Ensured adherence to key performance indicators related to resolution times and quality standards across all channels of communication.
- Researched and analyzed customer complaints to identify trends, potential root causes, and opportunities for improvement.
- Performed detailed data entry into internal tracking systems to ensure accurate resolution of customer issues.
- Monitored incoming customer service emails and phone calls, responding promptly and professionally to inquiries.
- Facilitated internal meetings to review escalated cases; identified areas of improvement and provided recommendations.
- Provided feedback on customer experience surveys by analyzing survey results for further action or improvement initiatives.
- Maintained up-to-date records of all interactions with customers using appropriate documentation techniques.
Surgical Assistant
Southern Kentucky Oral Surgery Associates
Bowling Green, KY
10.2018 - 05.2023
- Maintain accurate and precise electronic medical records.
- Effectively communicate with Doctors, nurses, management, and referring dental teams.
- Ensure accurate treatment plans and communicate effectively with patients and families.
Surgical Assistant
Saratoga County Oral & Maxillofacial Surgery Associates, PLLC
Saratoga Springs, NY
08.2010 - 08.2018
- Enthusiastically provides assistance in surgical procedures and IV sedation monitoring.
- Efficiently prepares surgical rooms and instruments utilizing aseptic techniques.
- Proficiently maintains an inventory of surgical and implant supplies.
- Effectively enters detailed patient dental treatment plans and charting.
- Independently obtains a variety of precise X-rays and digital impressions.
- Obtained ACLS, BLS, PALS, and DAANCE Certifications
Receptionist
US Oncology
Clifton Park, NY
10.2007 - 07.2010
- Answer and screen all incoming calls.
- Account for and scan checks along with an explanation of benefits.
- Verify all cash and co-pay logs.
Lead Dispatcher
Air Methods Corporation
Omaha, NE
01.2005 - 04.2007
- Participates in the training of new employees and assists in monitoring their progress.
- Promotes positive and effective communications between multiple agencies.
- Ability to work in a team environment under high-stress situations.
- Responsible for presenting a professional image in person, on the telephone, and radio.
- Handle overflow calls from other areas of the communications center.
- Implement emergency procedures, providing accurate and timely information to all agencies involved.
- Demonstrate outstanding customer service skills.
Education
Associate of Science - Science
South Central Community College
Bowling Green, KY08-2024
Emergency Medicine -
Mid Plains Community College
North Platte, NE01.1997
High School Diploma -
Wallace High School
Wallace, NE01.1995
Skills
- Case management
- Regulatory compliance
- Documentation management
- Medical terminology
- Process improvement
- Customer relationship management
- Data analysis
- Workflow optimization
- Performance monitoring
- Cross-functional collaboration
- Problem solving
- Effective communication
- Conflict resolution
- Time management
- Continuous improvement
- Team collaboration
- Problem-solving aptitude
- Conflict mediation
- Attention to detail
- Reading comprehension
- Multitasking capacity
- Task prioritization
- Conflict management
- Problem-solving
- Teamwork and collaboration
- Complex problem resolution
- Problem-solving abilities
- Interpersonal communication
- Adaptability and flexibility
- Reliability
- Analytical skills
Timeline
Complaint Resolution Coordinator
Medical Review Institute of America
07.2023 - Current
Surgical Assistant
Southern Kentucky Oral Surgery Associates
10.2018 - 05.2023
Surgical Assistant
Saratoga County Oral & Maxillofacial Surgery Associates, PLLC
08.2010 - 08.2018
Receptionist
US Oncology
10.2007 - 07.2010
Lead Dispatcher
Air Methods Corporation
01.2005 - 04.2007
Associate of Science - Science
South Central Community College
Emergency Medicine -
Mid Plains Community College
High School Diploma -
Wallace High School