Teresa Swor
Weatherford,TX
Summary
Energetic Supervisor successful at motivating and building positive team dynamics to accomplish aggressive goals. Dedicated to open, communicative culture where employees feel empowered to contribute to company's success.
Overview
25
25
years of professional experience
1
1
Certification
Work History
Supervisor of Customer Experience Team
Customer Experience And Provider Support
04.2022 - Current
- Co-supervisor of Customer Experience and Provider Support
- Successfully supervised staff of 11 direct reports
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Handled member/provider complaints, resolved issues, and assisted in adjusting processes to meet changing needs.
- Monitored workflow to improve employee time management and increase productivity.
- Improved member/provider satisfaction with timely response to inquiries, addressing concerns, and finding effective solutions.
- Maintained compliance with company policies, objectives, and communication goals.
- Evaluated employee performance and coached and trained to improve weak areas.
- Increased team productivity by implementing efficient workflows and setting clear expectations for staff members.
- Enhanced communication within our team by holding regular meetings and encouraging open dialogue among all team members.
- Collaborated with other departments to achieve organizational goals, fostering teamwork across various functions.
- Mentored junior staff members in their career development, sharing knowledge from years of experience in the field.
- Created successful work schedules for each team member to maintain deadlines and fully staffed shifts.
- Reduced employee turnover by fostering a positive work environment and providing ongoing feedback to staff members.
- Perform other managerial duties as assigned and needed
Benefit Consultant - Licensed Insurance Agent
BetterCare Insurance Services (AAG)
08.2021 - Current
- Using knowledge of the Medicare product to accurately assess the distinct needs of different prospects, explain the differences between various products, and assist the prospect member in selecting a product that best meets their unique needs
- Assist the prospect in the completion of the enrollment application over the phone with complete, accurate, and required information, consistent with Medicare requirements and enrollment guidelines
- Performed in high volume, high energy, fast-paced sales environment
- Meet and maintain requirements for agent licensure, appointments, and annual product certification
- Handle inbound and outbound calls to respond to inquiries, generate appointments, and follow up on leads, andreferrals.
Supervisor of Customer Experience Team
Care N Care Customer Experience Team SWHR
03.2021 - 08.2021
- Co-supervisor of the Customer Experience team
- Successfully supervising 11 direct reports
- Handled member complaints, resolved issues, and adjusted policies to meet changing needs.
- Claims review handling
- Responsible for daily, weekly, and monthly reports for team and Senior manager
- Handle member reimbursement requests for payment on out-of-pocket expenses
- Confirmation of completed form before sending to claims for review
- Log daily returned mail and assign to the team for review
- Assign calls to the team and perform the weekly audit
- Assist team and members with questions
- Approval of time clock biweekly and review and approval of time off request
- Perform other managerial duties as assigned and needed.
Manager of Healthcare Concierge
Care N Care Health Care Concierge NTSP
12.2018 - 03.2021
- Successfully manage a staff of 21 that includes 4 direct and 17 indirect reports
- Responsible for delivering on all Service, Retention, and Employee measures for the call center
- Identifies and manages hiring needs for the team
- Continuously evaluates processes for improvement
- Analyzes statistical trends and opportunities
- Maintains up-to-date products and service knowledge to support customers and direct reports
- Gives proactive feedback and recommendations to Leadership on business operations and performance
- Perform other managerial duties as assigned and needed.
Quality Control and Training Coordinator
Care N Care
05.2017 - 12.2018
- Provide training to staff for member education and counseling on access to services, benefits, and providers
- Strong understanding of all team processes and procedures
- Identify and report trends in gaps by call monitoring evaluations and satisfaction calls
- Responsible for daily, weekly, and monthly reports for team and Senior manager
- Assistance with daily tasks as necessary for maximum performance of business operations
- Maintain personal metrics to establish performance levels of the team
- Perform other duties as assigned and needed.
Supervisor of Healthcare Concierge
Care N Care Health Care Concierge NTSP
01.2017 - 05.2017
- Co-supervisor of Health Care Concierge team
- Responsible for daily, weekly, and monthly reports for team and Senior manager
- Handle member reimbursement requests for payment on out-of-pocket expenses
- Confirm the accuracy of the coding
- Log daily returned mail and assign to the team for review
- Assign calls to the team and perform a weekly audit
- Assist team and members with questions
- Approval of time clock biweekly and review and approval of time off request
- Perform other managerial duties as assigned and needed.
Supervisor of Silverback Care Management Call Center
Silverback Care Management Call Center NTSP
04.2016 - 12.2016
- Supervisor of Call Center team of 8 direct reports
- Assist with building and approving referrals for members
- Responsible for daily, weekly, and monthly reports for team and Senior manager
- Perform call audit
- Assist team and members with questions
- Approval of time clock biweekly and review and approval of time off request
- Perform other managerial duties as assigned and needed.
Practice Manager
THPG - Cityview Family Physicians
02.2010 - 04.2016
- Successfully supervise and manage a staff of 20 that includes provider, nursing, and clerical staff to ensure adequate coverage for quality patient care
- Establish and implement work procedures and standards to improve efficiency and effectiveness for the entire practice
- Assists Regional Director with implementation and development of long-range practice plans, budgets, and goals
- Manage front office operations and personnel to maximize patient satisfaction, patient access, maintenance of medical records, verification of benefits, timely and accurate charge entry, collection of payments (TOS), and customer service efforts
- Coordinate the scheduling of operations with that of the practitioner to ensure proper coverage of patient appointments and out-of-office calls
- Oversee the clinical staff hiring, performance management, and salary administration process
- Monitor payroll system to control time management
- Maintain a professional environment to comply and that meets the regulatory, licensure, compliance, and accreditation requirements
- Serve as the first point of contact for patient and external customer complaints and escalated issues
- Responsible for reconciling, investigating, and responding to all complaints relating to practice operations
- Liaison between the practice, Corporate Management, and Central Billing Office
- Cityview Family Physicians was recognized as one of the Top 5 Family Practice clinics with exceptional accounts receivable in 2015 with Texas Health Resources
- Perform other managerial duties as assigned and needed.
Front Office Supervisor
Cityview Family Physicians
07.2000 - 03.2010
- Responsible for overseeing the front office operations daily
- Responsible for all billing and collections of the clinic
- Coded all paper charge tickets into the billing software, reviewed of clean claims before going to the clearing house or mailing to the insurance companies
- Responsible for maintaining all staff schedules
- Delegated duties to office staff
- Responsible for staff annual reviews
- Scheduled all meetings for Physicians and Mid-Level providers.
Front Office Receptionist
Cityview Family Physicians
11.1999 - 07.2000
- Checked in/out of all patients
- Collected copayments, deductibles, co-insurances, past due balances, and prompt payments
- Verified patient benefits
- Billing of charges
- Posted of explanation of the benefits
- Assisted patients with insurance and billing questions
- Coded all paper charge tickets into t billing software, andreviewed clean claims before going to the clearing house or mailed to the insurance companies.
Education
High School Diploma -
Aledo High School
Aledo, TX06.1990
Skills
- Medical Practice Management
- Health Plan Management
- ICD-9/10 knowledge
- CPT/HCPCS Coding knowledge
- Training New Hires and Established Team Members
- Employee Orientation
- Strong Communication with members/providers/patients/team
- Exceptional Escalation call handling
- Strong Customer Service
- EMR Systems
- Benefits/Eligibility Knowledge
- Medical Billing, Claims & Terminology
- Microsoft Office
- Licensed Insurance Agent
- Staff Development
- Staff Discipline
- Schedule development
Accomplishments
Successfully resolved escalated customer issues, resulting in 3% decrease in customer complaints
Fostered a positive and supportive team culture resulting in high morale and low turnover rates
Implemented performance tracking system that provided actionable insights for employee performance
Acknowledge for being one of Humana's - DFW's top “newly certified” agents for 2021 021 Annual Enrollment Period
Acknowledged for being one of Aetna's – DFW's Sales Champions for the D-SNP division for 2021 Annual Enrollment Period
Certification
- Certified Professional Coder (CPC), AAPC, 2006, Current
- Licensed Insurance Agent, 2021, Current
Groups
American Academy of Professional Coders
Timeline
Supervisor of Customer Experience Team
Customer Experience And Provider Support
04.2022 - Current
Benefit Consultant - Licensed Insurance Agent
BetterCare Insurance Services (AAG)
08.2021 - Current
Supervisor of Customer Experience Team
Care N Care Customer Experience Team SWHR
03.2021 - 08.2021
Manager of Healthcare Concierge
Care N Care Health Care Concierge NTSP
12.2018 - 03.2021
Quality Control and Training Coordinator
Care N Care
05.2017 - 12.2018
Supervisor of Healthcare Concierge
Care N Care Health Care Concierge NTSP
01.2017 - 05.2017
Supervisor of Silverback Care Management Call Center
Silverback Care Management Call Center NTSP
04.2016 - 12.2016
Practice Manager
THPG - Cityview Family Physicians
02.2010 - 04.2016
Front Office Supervisor
Cityview Family Physicians
07.2000 - 03.2010
Front Office Receptionist
Cityview Family Physicians
11.1999 - 07.2000
High School Diploma -
Aledo High School
- Certified Professional Coder (CPC), AAPC, 2006, Current
- Licensed Insurance Agent, 2021, Current
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