Sydney Burgess
Fairview,TX
Summary
Results-oriented professional with vast experience in streamlining business processes and providing strategic direction. Proven track record of reviewing inquiries for accuracy, providing personalized feedback, and implementing new techniques to increase employee performance. A lifelong learner skilled in compliance monitoring and project management. Proficient in Lean Six Sigma methodologies, Microsoft Suite, and quality auditing management systems to drive efficiency and effectiveness.
Overview
8
8
years of professional experience
Work History
SR. QUALITY TRAINING & KNOWLEDGE MANAGEMENT COACH
Blue Cross and Blue Shield of Texas (HCSC)
2021.10 - Current
- Coached 50+ new hire Customer Advocates across 6 lines of business through one on one sessions to assess gaps in understanding and provide constructive feedback, adapting new coaching methods based on individual needs and adult learning preferences using the IDEA model
- Analyzed customer service operations for legal accuracy and compliance with government regulations such as HIPAA, TCPA, and provider network contracts
- Created reports on findings from quality assurance audits, presented to senior management team
- Led calibration sessions with stakeholders to identify root cause and presented recommendations for updates to future training material
- Developed adult education resources such as job aids, templates, and handouts to enhance new hire learning experiences
HEALTH ADVOCACY CONCIERGE
Blue Cross and Blue Shield of Texas (HCSC)
2019.06 - 2021.10
- Subject matter expert on benefits, claims processing, and wellness programs through telephonic outreach
- Piloted the rollout of ACE-Salesforce member engagement dashboard, Cogito call analyzing systems and COVID Outbound Initiative Outreach project
- Connected individual and families with community resources such as housing, transportation, food assistance, and social services to aid decision-making around complex health issues
- Processed high volume of incoming claims according to established quality and production standards and made adjustments as necessary
- Initiated conversation between patients and other healthcare professionals to ensure emphasized adherence to the member's personal plan of care
INSURANCE SALES REPRESENTATIVE
All Web Leads Inc.
2017.06 - 2017.11
- Successfully utilized strong problem-solving skills to effectively mediate customer concerns, while organizing and accurately maintaining filing systems of confidential information
- Analyzed customer needs to determine appropriate coverage types and levels of protection
- Generated new business through cold-calling, networking, referrals, and other lead sources
CUSTOMER SERVICE REPRESENTATIVE
Alorica Business Solutions
2016.06 - 2017.05
- Disseminated benefit and eligibility information while resolving billing and payment issues, and handling other physician requests
- Maintained detailed records of customer interactions, transactions and comments for future reference
- Increased service goals and customer satisfaction ratings by effectively answering questions, suggesting effective solutions, and resolving issues quickly
- Complied with corporate and regulatory policies regarding information confidentiality and HIPAA privacy
Education
Bachelor of Arts - Psychology
THE UNIVERSITY OF TEXAS AT SAN ANTONIO
05.2019
Master of Science - Health Studies
TEXAS WOMAN’S UNIVERSITY
Skills
- Compliance/performance monitoring
- Lean Six Sigma Methodologies
- Quality Management Systems
- Root Cause Analysis
- Quality auditing
- Training and development
- Critical thinking
- Project management
- Interpersonal skills
- Attention to detail
Certifications
- Lean Six Sigma Yellow Belt
- Certified Community Health Worker (TX)
Timeline
SR. QUALITY TRAINING & KNOWLEDGE MANAGEMENT COACH
Blue Cross and Blue Shield of Texas (HCSC)
2021.10 - Current
HEALTH ADVOCACY CONCIERGE
Blue Cross and Blue Shield of Texas (HCSC)
2019.06 - 2021.10
INSURANCE SALES REPRESENTATIVE
All Web Leads Inc.
2017.06 - 2017.11
CUSTOMER SERVICE REPRESENTATIVE
Alorica Business Solutions
2016.06 - 2017.05
Bachelor of Arts - Psychology
THE UNIVERSITY OF TEXAS AT SAN ANTONIO
Master of Science - Health Studies
TEXAS WOMAN’S UNIVERSITY
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