Susan M Quinlan
Hudson
Summary
I have completed a semester at the University of Miami, and received a certificate from the University, as a Patient Advocate. My goal is to use that knowledge to help others navigate through the healthcare system successfully, and with a better understanding of how to manage their's and their loved ones in the future. I am an experienced customer service representative with excellent communication skills. I have worked with private and government agencies to assist clients in resolving issues with their various programs, systems, and service contracts in their call centers. I have worked in the insurance industry and held a life/annuity/health Insurance (Florida 2023), Banking, Finance, and IT. I have worked in a remote call center environment for over 5 years dealing with patients, Medical office personnel and Site/facility personnel to create new requests for services, and resolve issues with existing services.
Professional with strong background in customer interactions and service solutions. Highly skilled in conflict resolution, communication, and problem-solving, ensuring customer satisfaction and loyalty. Effective team collaborator, adaptable to changing needs, and consistently focused on achieving results through efficient and empathetic service. Known for reliability and proactive approach to meeting customer and organizational goals.
Overview
1
1
Certification
19
19
years of professional experience
Work History
Customer Service Representative/Member
eviCore/Cigna
02.2022 - Current
- As a Member/Patient Intake Representative in eviCore healthcare’s Non-Clinical Call Center, serve as the main point of contact for inbound callers (Members/patients only) assisting them in setting up procedures, and assist in managing the member's expectations and understanding of medical reasoning exhibited on their case.
- This includes strong listening skis to assist members with understanding procedures requested by their physicians (MRI, CT, surgeries, cardiac, cancer). Being able to emphasize and help them feel heard and understood. Building rapport and solving issues
- Provide status updates and serve as a liaison to clinical staff (nurses, clinical reviewers) when needed
- The ability to multitask will be key, while listening, entering information, completing Internet searches, and asking probing questions to better understand and emphasize with their unique situations.
- Work with sites, patients and physician’s offices to investigate and resolve any pre-certification questions or concerns and preempt unanticipated issues
- Provide professional, courteous and accurate information to all callers
Insurance Business Consultant/Agent
Aflac - Southeast Region - Tampa Bay Area
07.2019 - 05.2022
- Working with small businesses in the Tampa Bay area, helping owners to offer supplemental insurance benefits to their employees through Aflac. Helping the owners improve their profits by offering benefits that help them attract and retain top talent.
Customer Service Representative (sales)
Asurion
08.2021 - 02.2022
- Able to handle a high volume of customer calls in a fast paced environment, with minimum supervision, while maintaining emphasis on highest quality of consumer service. Excellent listening skills, reliable, hard working, and dedicated team player who works well under pressure.
- Answer inbound calls from customers experiencing issues with their covered devices (phones, tablets, hot-spots)
- Answer client questions, assist them in creating claims to repair or replace their device
- Troubleshoot claims processing with various departments; adjusters, tech support, provider customer care
- Upsell additional warranty product and personal infomation protection
Consultant/Contractor
Kforce
08.2020 - 07.2021
- Working through Kforce as a consultant/contractor for various projects for the State of Florida, along with Titan Technologies, and Maximus staffed contracts
- 5/2021- July/2021 (Work from Home assignment, Titan Technologies)
- Working with the State of Florida, Department of Children and Families Services, DCF, to assist claimants with P-EBT benefits (School Lunch) and eligibility
- Answer calls and callbacks from claimants and answering questions on eligibility for P-EBT benefits
- Using the Access system in verifying callers as student’s guardian before discussing any student information
- Using the Access System to identify benefits paid for enrollment periods, by student name and DOB or SSN.
- Assisting the parent/guardian in resolving issues with address, and cards not received.
- Completing Requests for Review for students that did not receive benefits but were eligible.
- Work to remove barriers holding student’s benefits.
- 1/2021-5/2021 (Work from Home assignment, Titan Technologies)
- Working with the State of Florida Department of Economic Opportunity, DEO, to assist claimants using the unemployment system.
- Answer calls and callbacks from claimants to create new claims.
- Answer calls and assist claimants in understanding their claims and what information the DEO needs to continue to pay benefits.
- Assist claimants with Fraud and Identity Theft issues. Enter forms and alerts as needed.
- Work to remove barriers holding claimant’s benefits.
- 8/2020 – 12/2020 (Work from Home assignment, Maximus)
- As a Covid-19 Case Investigator, making outbound calls to Covid-19 patients to gather epidemiological information to be used in the management of the spread of Covid-19.
- Call cases assigned via the State of Florida’s CRM database
- Handle issues with cases that need updating
- Work with patients to gather info and help them with questions
- Gather information on contacts for contact tracing process
Call Representative
Dial America
03.2019 - 06.2019
- As an inbound call representative for multiple large retail companies, answered client calls to verify/activate their credit card, and explaining debt protection options being offered.
- Identifying and resolving customer issues using problem-solving skills
- Building a positive rapport across a variety of personality types
- Continually maintaining a working knowledge of our clients’ products, services and promotions
- Putting the customer first and remaining polite and professional at all times
- Documenting all customer information, communications, and sales in a computer system
Business Analyst/Consultant, Lead Test Analyst, PSM 1 - Certified Scrum Master
Northwestern Mutual Life Insurance - Milwaukee/Franklin Wisconsin
02.2007 - 04.2017
- As an IT professional I worked in several areas of IT, business, development, programming, and networking. I led teams in creating and refining requirements to meet the business, IT, and end user needs, developing extensive test plans to verify new and upgraded programs, and implementing the final product in the business system environment.
Education
BS - Computer Science
Concordia-CA
01-2001
Skills
- Certified healthcare advocate
- Proficient MS Office Suite
- Certified COVID-19 Contact Tracer
- Experienced Call Center Representative
- Experienced Insurance Sales Representative
- Strong understanding of Medical Terms
Certification
- PSM - 1/2016
- SAFe Practitioner - 1/2017
- COVID-19 Contact Tracer - 5/2020
- FEMA Disaster – 8/2020
- Patient Advocate/Univ. of Miami 2023
- Florida 2-15 Health, Life, and Variable Annuities-current
Timeline
Customer Service Representative/Member
eviCore/Cigna
02.2022 - Current
Customer Service Representative (sales)
Asurion
08.2021 - 02.2022
Consultant/Contractor
Kforce
08.2020 - 07.2021
Insurance Business Consultant/Agent
Aflac - Southeast Region - Tampa Bay Area
07.2019 - 05.2022
Call Representative
Dial America
03.2019 - 06.2019
Business Analyst/Consultant, Lead Test Analyst, PSM 1 - Certified Scrum Master
Northwestern Mutual Life Insurance - Milwaukee/Franklin Wisconsin
02.2007 - 04.2017
BS - Computer Science
Concordia-CA