Teresa Carson
Ringgold,Georgia
Summary
Membership Account Specialist with strong background in self-funded billing and data reconciliation at BlueCross BlueShield of Tennessee. Demonstrated success in improving operational efficiency and building cross-departmental relationships. Expertise in problem-solving and training development, ensuring compliance and high-quality service. Focused on achieving outstanding results in account management.
Overview
26
26
years of professional experience
Work History
Membership Account Specialist
BlueCross BlueShield of Tennessee
Chattanooga, TN
08.2019 - Current
- Responsible for billing and membership of designated groups for the Cost department and maintaining excellent quality.
- Responsible for communications to groups on how to understand billing statements, administrative fees, payments, processing applications, and eligibility requirements.
- Assisted account managers and brokers on updating employee’s information in the Facets and ESI system in a timely manner.
- Provided consulting services and solutions for groups/brokers, Marketing, SPOC, and Regional Service Specialists.
- Prepared daily reports that involve assuring that groups have paid their premiums in full and reconciling accounts.
- Researched and explained sensitive group issues with account managers and supervisor.
- Developed and maintained strong working relationships with other divisions such as SPOC, COBRA, and Marketing.
Operations Supervisor
BlueCross BlueShield of Tennessee
Chattanooga, TN
02.2017 - 08.2019
- Identified all issues concerning the team and provide continuous support to all members according to operating standards.
- Supervised effective working of production personnel and prepare effective production schedules and ensure compliance to all company policies.
- Coordinate with equipment and process teams ensuring compliance to all protocols and maintain quality.
- Prepare vacation schedule for all employees maintaining continuous production.
- Ensure compliance to all local policies to achieve all production objectives and provide appropriate feedback to all employees.
- Developed and maintained effective relations with all company employees at various levels of organization.
- Prepared necessary paperwork and administered all invoices on spreadsheet and maintain records of all documents.
- Analyzed staffing requirements and ensured efficient compliance to production schedules and budget for all production process.
- Managed team of 15 of professionals.
- Ensure compliance to workplace policies according to safety objectives.
Cashier
Kmart, Sears Holding
Chattanoog, TN
07.2016 - 10.2017
- Resolved customer complaints professionally in accordance with company policy.
- Performed other duties as assigned by management.
- Issued receipts, refunds, credits or change due to customers.
- Followed company security procedures for handling large sums of money.
- Maintained cleanliness of checkout area including countertops, registers, windowsills and floors.
- Answered customer inquiries regarding store policies and procedures.
- Greeted customers and answered any questions they had about the store's products and services.
- Operated cash register efficiently and accurately, processed payments by cash, check, credit card, gift card or automatic debit.
- Balanced daily transactions on a computerized point-of-sale system.
- Provided excellent customer service while promoting loyalty programs to increase sales potential.
- Kept records of purchases; maintained orderly appearance of checkout area; restocked supplies as needed.
- Helped customers find specific products, answered questions, and offered product advice.
- Delivered high level of customer service to patrons using active listening and engagement skills.
Regional Team Leader
BlueCross BlueShield of Tennessee
Chattanooga, TN
11.1999 - 01.2017
- Was responsible for the supervision and management of the Membership Admin Account Specialists and ensuring that all components of the associates job functions are accurate for the WEST FI BEST team.
- Various responsibilities including quality checks, training, and performing desk audits to ensure the associates are processing timely and accurately.
- Provided excellent customer service to our vendors both internal and external including group administrators, brokers, SPOC, account managers, enrollment specialist, and other areas of the company.
- Provided additional training to associates to maintain excellent quality and pride performance.
- Monitored all aspects of the department to assist the supervisor in adequate coverage and training to optimize peak performance.
- Proactively attended workgroups and meetings to maintain up to date knowledge for associates to perform their job functions accurately and timely.
- Multi-task multifaceted projects to assure accurate quality and completion rates for groups and members.
Cashie
Home Depot
Chattanoo, TN
02.2008 - 03.2010
- Ensured compliance with all safety regulations within the store environment.
- Followed company security procedures for handling large sums of money.
- Kept records of purchases; maintained orderly appearance of checkout area; restocked supplies as needed.
- Greeted customers and answered any questions they had about the store's products and services.
- Provided excellent customer service while promoting loyalty programs to increase sales potential.
- Performed other duties as assigned by management.
- Balanced daily transactions on a computerized point-of-sale system.
- Maintained cleanliness of checkout area including countertops, registers, windowsills and floors.
- Processed returns and exchanges of merchandise in accordance with store policies.
- Operated cash register efficiently and accurately, processed payments by cash, check, credit card, gift card or automatic debit.
- Answered customer inquiries regarding store policies and procedures.
- Issued receipts, refunds, credits or change due to customers.
- Stocked shelves with merchandise when needed.
- Resolved customer complaints professionally in accordance with company policy.
- Preserved appearance of store by arranging and replenishing displays and merchandise racks.
- Accepted cash and credit card payments, issued receipts and provided change.
- Operated cash register or POS system to receive payment by cash, check and credit card.
- Discounted purchases by scanning and redeeming coupons.
- Counted money in cash drawers at the beginning of shifts to ensure amounts were correct.
- Processed credit card, cash, and check payments, ensuring all transactions were accurate.
Education
Bachelor’s Degree - Business Administration
Bryan College
Dayton, TN12.2013
Skills
- MS Office applications
- Facets/Mainframe experience
- Self-Funded Billing
- IER Billing
- HRA Administration
- FSA administration
- Lean Six Sigma Yellow Belt
- Express Scripts
- Facets Testing
- Enrollment Database
- Transcentra Financial Database
- Web Client
- Workflow
- Membership OLH
- OnDemand Viewer
- USAble Website
- Accounts Receivables
- AIM program
- Problem solving
- Training development
- Billing management
- Data reconciliation
- Account management
Qualifications Summary
- Team oriented with exceptional interpersonal and presentation skills to help the team succeed.
- Confident professional communicator with outstanding verbal and listening skills.
- Self-motivated with an excellent customer service background.
- Adept at managing a team in a fast paced and challenging department and working well under pressure with tight deadlines.
- Detail oriented and can quickly adapt to a quickly changing environment.
- Analytical and self-starter on process improvement within the department and focused on real solutions to problems.
- Proven decision making and problem-solving skills.
- Understands corporate policies and procedures.
- A team player with the ability to handle multiple tasks and organized.
Timeline
Membership Account Specialist
BlueCross BlueShield of Tennessee
08.2019 - Current
Operations Supervisor
BlueCross BlueShield of Tennessee
02.2017 - 08.2019
Cashier
Kmart, Sears Holding
07.2016 - 10.2017
Cashie
Home Depot
02.2008 - 03.2010
Regional Team Leader
BlueCross BlueShield of Tennessee
11.1999 - 01.2017
Bachelor’s Degree - Business Administration
Bryan College
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