Sharon Nieto
Cypress,CA
Summary
As a Quality Assurance Director my primary objective is to support the functioning of business operations by quality controlling our assistance call center teams. Along with managing staff’s KPIs on auditing calls, chats and emails to providers and members ensuring exceptional customer service. QA setting clear goals, monitoring performance, and communicating with the executive team, managers, supervisors, and member service coordinators, I strive to create a positive and productive work environment. Veteran Quality Assurance Lead provides critical support maintaining QMS standards. Over 5] years of experience performing necessary QA audits and pulling key data to assemble detailed analytical reports. Maintained high quality threshold levels, overseeing comprehensive technical framework drafts and reviews. Issued detailed calls-to-action, noting criteria and obstacles to quality management system effectiveness.
Overview
18
18
years of professional experience
Work History
Quality Assurance Director
Global Benefits Group – GBG Assist (Call Center Support)
04.2019 - 03.2024
- Quality Assurance supported the GBG Assist Call Center which offered 24/7 customer support to GBG’s members who were insured under a group or individual health, life, disability, travel policy
- GBG Assist was a central point for providers and members to contact for policy benefits and emergency evacuation
- Analyzes and sets productive goals for MSC (member services coordinators)
- Assist new hire candidate selection, onboarding new hires, training, coaching, and identifying those high performing MSC with quality customer service skills
- Monitor daily MSCs calls, chats and emails to members and providers ensuring professional customer service
- Monthly audits to call center managers provide coaching, individual audit trends; provide SLA reports and ensuring KPIs are met
- Strategizing for continuous quality improvement
- Work closely with Training Manager to provide trends identified with MSC’s as a whole or individual where corrective action needed
- Share scorecard audits on monthly basis which impacts mid-year and annual evaluations
- Provide support during disciplinary or termination of a MSC
- Resolving customer/provider complaints which may entail investigation of root causes, policy understanding, management involvement or procedural changes
- This may entail varies department such as Legal, Claims and Sales team
- Established a corporate quality assurance process that promotes member satisfaction
- Work closely with executive customer service officer and stakeholders
- Weekly and monthly meeting to provide SLA reports, auditing scorecards, new and updated P and P, and complaint reporting from all regions
- Created, maintained and reported monthly customer service satisfaction improvement (NPS) via SurveyMonkey to the executive team and call center managers
- Served with project team as SME on a quality proprietary system application.
Client Services Manager (promoted to Director)
Global Benefits Group
09.2006 - 03.2019
- GBG provided individual and group policies direct or reinsured basis across US, Latin America, Europe and part of Asia
- With offices in US, Belgrade, London, Hyderabad, and Shanghai
- The Client Service Department managed international educators/inbound scholastic students, Employee Group and Individual Health, Life, Disability and Travel policies to expatriates
- The department’s goal is to provide exceptional customer service to existing and new clients, brokers, agents, TPAs, and members
- Highlight of the department: Create teamwork within the department, internal and regional offices
- Meeting target dates by ensuring our international educators receive their enrollment packets as educators return to school
- Time management to ensure our clients, brokers and members are enrolled and providing billing
- Meeting expectations of new, renewing, extension policies
- Collaborating with departments on bids/RFPs
- Retaining staff with opportunities to grow
- Working closely with other departments and the regional offices
- Monthly meetings with Sales team to analyze client data, identify trends, and develop strategies to implement policies for prospective new clients and returning clients
- Monthly meetings with Claims team to ensure P&L are reviewed and identified
- Managing expectations, deadlines, resolving complaints, and staff evaluations
- Reporting to executive committee adhoc reports, spreadsheets and DOMO reports of current trends
- Project team as SME (subject matter expert) on proprietary system applications.
Education
Associates in Business Administration -
Cypress Community College
Cypress, CASkills
- Proficient Microsoft Office
- Creating Policy and Procedures
- Project Management
- Communication
- Analytical Skill
- Customer Service
- Problem-Solving
- Teamwork
- QA
Professional References
- Scott Sanders, Executive Head Customer Service, Global Benefits Group – GBG Assist, 603-465-8292, scottesanders@hotmail.com
- Teresa LaVecchia, VP, Underwriter (retired), Global Benefits Group, 714-928-1037
- Clifford “Ford” Allen, President and CEO, CAA – Clifford Allen Associates, 843-342-3150, ford@cliffordallen.com
- Johnna Friddell, Director, Operations, CAA – Clifford Allen Associates, 843-342-3150, johnna@cliffordallen.com
- Teri Frank, VP, Human Resources, Total Scholastic Solution (formerly Global Benefits Group), 949-636-4131, teri.frank@gbg.com
- Mitra Labarre, Head Counsel, Legal, Total Scholastic Solution (formerly Global Benefits Group), 949-290-9630, mitra.labarre@gmail.com
Personal Information
Title: Quality Assurance/Client Services Director
Timeline
Quality Assurance Director
Global Benefits Group – GBG Assist (Call Center Support)
04.2019 - 03.2024
Client Services Manager (promoted to Director)
Global Benefits Group
09.2006 - 03.2019
Associates in Business Administration -
Cypress Community College
Similar Profiles
Tiarra DennisTiarra Dennis
Offsite Administrative Support Patient Service Representative at Mt. Sinai Hospital Network Patient Support Center Call CenterOffsite Administrative Support Patient Service Representative at Mt. Sinai Hospital Network Patient Support Center Call Center
NICOLE OLOTEONICOLE OLOTEO
Nurse Case Manager at Global Benefits GroupNurse Case Manager at Global Benefits Group
Jasmine DorceJasmine Dorce
Member Service Coordinator at Global Benefits GroupMember Service Coordinator at Global Benefits Group