Sean Tessier
Chittenango,N.Y.
Summary
Dedicated Supervisor with 22+years of healthcare experience. Consistently achieved high customer service rankings by focusing on ways to enhance business processes and services. Respected leader of customer-focused and quality assurance teams. Motivated and inspired team members to commit to a higher standard of production and service. Ensured quality and performance levels were achieved for claim, quality assurance, telephone, and correspondence functions. Tenacious energy with a desire to constantly reinvent myself, my role and the healthcare world. A belief that how we treat each other is as important as what we achieve.
Overview
22
22
years of professional experience
Work History
Quality Assurance Supervisor
Smart Data Solutions
Eagan, MN
09.2023 - Current
- Successfully managed and supervised a team of 15 staff responsible for performing BPO medical claims processing and audit activities, contributing to the growth of a new line of business within the organization.
- Developed and implemented Quality Assurance policies, procedures, and standards.
- Identifies, analyzes, and reports on quality results, performance trends and metrics, and communicates short-term and long-term goals to management.
- Communicates and reinforces departmental goals, assists team members in achieving established annual goals, and maintains metrics relating to team and individual goals.
- Monitor team production, SLA and KPI to ensure client deliverables are met as per the contract.
- Supervised onboarding and training of new personnel to maximize capacities of team.
- Monitored corporate and department procedures for adherence by employees, notifying personnel of non-compliance issues.
Quality Assurance Supervisor
NTT DATA Services
Quincy, MA
10.2022 - 09.2023
- Supervise and direct Business Process Outsourcing (BPO) QA staff with a wide variety of quality assurance audits, analysis, and projects.
- Monitor team production, SLA and KPI to ensure client deliverables are met as per the contract.
- Monitor team performance and reviewed results with each team member along with reporting results and issues to higher level leadership.
- Identify, recommend, and implement process improvements to increase efficiency, client service levels and financial results.
- Oversee staff attendance, and other administrative duties.
- Leads staff to complete assignments using established guidelines, policies, and procedures.
Supervisor Customer Service Employer & Individual
UMR- A UnitedHealthcare Company
Syracuse, NY
01.2019 - 10.2022
- Supervised staff of 9-16 people.
- Assisted in development of policies/procedures to enhance quality and performance.
- Monitored staff metrics and performance to meet corporate performance goals by providing ongoing coaching and feedback to staff.
- Assisted staff in resolution of sensitive calls or inquiries of a priority nature.
- Decisions are guided by policies, procedures, judgement, and business plan.
- Ability to communicate difficult/sensitive information tactfully.
- Experience with Microsoft Word, Excel, Outlook, NICE, Webex, MyMetrics, Qfinity, Qualtrics, CMS Supervisor, WAUBEN, OnBase, CPS, VCC, Nexidia Analytics, Facets, Siebel, MACES, HealthRules Manager, Metavance, QuickClaims, Time Doctor
Clinical Administrative Coordinator
UnitedHealthcare
East Syracuse, NY
06.2015 - 01.2019
- UnitedHealthcare Community & State Plan NY
Order Management Representative
Time Warner Cable
Syracuse, NY
09.2014 - 05.2015
Customer Service Representative
Time Warner Cable
Syracuse, NY
12.2013 - 09.2014
Manager
Strategic Claims Solutions
Chittenango, NY
10.2011 - 12.2012
Customer Service Supervisor
Emblem Health
Syracuse, NY
08.2005 - 03.2011
- Promoted to supervisor position to train and supervise 17+ call center customer service representatives
- Assisted manager in overseeing the day-to-day responsibilities of telephone performance and the processing of claims and inquiries from subscribers, hospitals, and providers.
Customer Service Representative
Emblem Health
Syracuse, NY
07.2002 - 08.2005
Skills
- Quality Measurement/Improvement
- Quality Assurance
- Internal and External Auditing
- Coaching/Feedback
- Payment Integrity
- Care Management
- Medicare/Medicaid
- Complaint Resolution
- Customer Service Management
- Claim Coding
- Medical Terminology
- ICD-10 Codes
- CPT Codes
- HIPAA Compliance
- Customer Service Enhancement
- Contract Compliance
- Fraud Awareness
- Corrective Action Planning
- Training and mentoring
- Performance monitoring
- Process Improvement
- Staff Development
Timeline
Quality Assurance Supervisor
Smart Data Solutions
09.2023 - Current
Quality Assurance Supervisor
NTT DATA Services
10.2022 - 09.2023
Supervisor Customer Service Employer & Individual
UMR- A UnitedHealthcare Company
01.2019 - 10.2022
Clinical Administrative Coordinator
UnitedHealthcare
06.2015 - 01.2019
Order Management Representative
Time Warner Cable
09.2014 - 05.2015
Customer Service Representative
Time Warner Cable
12.2013 - 09.2014
Manager
Strategic Claims Solutions
10.2011 - 12.2012
Customer Service Supervisor
Emblem Health
08.2005 - 03.2011
Customer Service Representative
Emblem Health
07.2002 - 08.2005
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