Summary
Overview
Work History
Education
Skills
Timeline
Generic

Tammy Richardson

East Hartford,CT

Summary

Adept Resolution Specialist with a proven track record at Veyo/MTM, showcasing exceptional problem-solving and written communication skills. Spearheaded complaint resolution, ensuring 100% adherence to client SLAs and significantly enhancing service quality. Excelled in teamwork and multitasking, driving improvements in customer satisfaction and operational efficiency.

Overview

29
29
years of professional experience

Work History

Resolution Specialist

Veyo/MTM
Windsor, CT
02.2019 - Current
  • Document, review, investigate, resolve, and provide follow-up for all complaints and complaint issues reported for assigned clients within the specified timeframe.
  • Closely adhere to client service level agreements to ensure complaints do not go out of compliance
  • Obtain responses within 24-48 hours from Transportation Providers to complaints and complaint issues
  • Provide immediate follow up for complaint responses that are not submitted within the specified timeframe
  • Respond to client, Program Director, or Account Executive inquiries sent via email, or fax, within the specified timeframe
  • Ensure accuracy of information in report prior to deadline submission
  • Triage issues and provide assistance to MTM's internal departments with complaint issues
  • Assist with monthly trending information in regards to potential network inadequacies, transportation provider deficiencies, and training opportunities to applicable departments; report trends to leadership for further review
  • Monitor and reporting incident/accident issues
  • Monitor and report issues of non-compliance to the leadership staff and Network Management as indicated
  • Compile weekly/monthly summaries of incident/accident investigations, findings, and resolutions as required
  • Send out monthly Quality & Compliance Tips to transportation providers and Network management regarding prevention measures identified
  • Ensure all training documents received per Q&C request
  • Create relevant workflows, and tracking mechanisms as assigned
  • Perform activities and participate in quality improvement projects for the Quality improvement Program(s) as assigned to ensure ongoing compliance with URAC standards
  • Compile daily/weekly/monthly complaint reports to be submitted to designated clients per contract

Customer Service Representative

TruGreen
Windsor, CT
05.2013 - 02.2019
  • Provided accurate information about products and services to customers.

Medical Claims Processor

CareCentrix
Hartford, CT
06.2007 - 05.2013
  • Processed claims for payment or forwarded to appropriate personnel for further investigation

Disability Case Manager

Metlife
Bloomfield, CT
02.2003 - 06.2007
  • Conducted telephone interviews with claimants to gather information regarding their medical conditions.

Customer Service Representative

Kelly Services
Enfield, CT
09.2002 - 02.2003
  • Answered customer inquiries and provided accurate information regarding products and services.

Case Manager

Aetna
Hartford, CT
01.1996 - 09.2002
  • Investigated medical records and gathered evidence in support of approved or denied claims.

Education

Some College (No Degree) - Business Administration and Management

Norfolk State University
Norfolk, VA

Skills

  • Assertiveness
  • De-escalation techniques
  • Written communication
  • Problem-solving
  • Reliability
  • Teamwork
  • Multitasking capacity

Timeline

Resolution Specialist

Veyo/MTM
02.2019 - Current

Customer Service Representative

TruGreen
05.2013 - 02.2019

Medical Claims Processor

CareCentrix
06.2007 - 05.2013

Disability Case Manager

Metlife
02.2003 - 06.2007

Customer Service Representative

Kelly Services
09.2002 - 02.2003

Case Manager

Aetna
01.1996 - 09.2002

Some College (No Degree) - Business Administration and Management

Norfolk State University

Similar Profiles

CREATE PROFILE
Tammy Richardson