Tonya Fox

• Quality Assurance Specialist, ALTICE USA, Piscataway, NJ, 2022-02-22, Present, Perform Quality Assurance audits in accordance with Department policy to maintain service and customer satisfaction goals. Demonstrate ability and full understanding of all the Company's products and services. Creatively approach problems in new and diverse ways that lead to innovative solutions. Must be able to accurately find root cause for complex problems, recommend and apply proper interventions to avoid future occurrence. Find broken processes that negatively affect the customer experience and escalate as proper. Find actions that violate policy or do not protect the business, by trained or documented call handling policy/processes and escalate for managerial consideration of status changes for active BPO employees based on performance and/or behavior saw. Act as a conduit for continuous improvement by raising issues that are consistently observed with regards failure to comply with processes or technology deficits. Document Quality Audit observations within the QA solution to document findings.
• Sr Associate Quality Assurance Operations, ConnectiveRx, Whippany, NJ, 2020-08-01, 2022-02-28, My primary responsibility was to monitor random calls for a dedicated campaign. All calls were obtained through Five9 and were evaluated using an internal Scorecard. I monitored random claims obtained through the Crx platform, Select Rx, TMG3 and NESSCE for accuracy. All claims were evaluated using an internal Scorecard. All evaluations were measured according to QA call and claims guidelines as well as work instructions and FAQs provided by the leadership team. The purpose of this was to obtain a desired level of quality in a service through customer calls or claims interactions. This process also included coaching agents and supplying feedback for various interactions received and handled within the ConnectiveRx contact call center. I also, conducted audit coaching sessions held bi-weekly with the associates and invited their supervisors. I was at times responsible for presenting calls for review and QA Data Analysis that included Critical Errors, QA Performance, Top Opportunities, and Agent Performance during client calibrations. I took part in call redacting when asked. I took notes of feedback and “take always “discussed during client and internal calibration sessions. These calibration sessions were used for coaching and development of associates. I was also responsible for reporting call trends which included missed opportunities and excessive call handle times. In addition to call trends, I reported background noise tracking, alignment updates and escalated appeals. My monthly productivity goals are on average 365 calls, which was met.
• Sr Associate Team Lead Patient Affordability, ConnectiveRx, Whippany, NJ, 2018-12-01, 2020-08-31, My primary responsibilities as a Sr Associate were to serve as a people leader handling ensuring that my team supplied extraordinary patient concierge health care services, enabling access to care for prescription medications. I worked with directly with 5-10 staff members and potentially our patients, physicians, and/or pharmacies related to supplying access to care on behalf of our clients ‘copay aid programs. I fostered an environment of active employee engagement and world class customer service. I monitored workloads and rebalanced them as needed in addition to managing attendance. I handled escalated patient calls, conducted one-on-one training and coaching sessions to develop Associate’s skills and competencies. I reported KPI’s (key performance indicator), engaged in other internal areas such as Program Management, IT, and other Contact Center teams to aid with resolving issues. I supplied input and feedback to Quality Management and Training as a subject matter expert to improve processes, procedures, and training. Managed daily staffing needs by monitoring time off and performance reports to meet call center metrics. Monitored phone queue dashboards via Five9 throughout the day and adjusted skills and resources to achieve Service Level Agreements and ensure all calls are taken/returned by the end of every day. I also, sent daily call feedback emails to Agents with Quality Assurance results focusing on superior quality performance as well as missed opportunities. Conducted regular individual coaching sessions to review performance.
• Supervisor- Medical Billing, SCV Medical Billing & Coding Services, Roselle Park, NJ, 2012-01-01, 2017-12-31, I used all available tools to ensure effective leadership, planning, and managing functions within SCV Medical Billing Services. Developed a highly efficient administrative team through ongoing coaching and professional development opportunities. Ensured that agents acquired the proper support, tools, and training to apply skills and knowledge on their job. Practiced and ensured compliance with HIPPA, SCV Medical Billing Service guidelines as well as client policies and procedures. Organized weekly team meetings for inbound call Associates as well as Medical Billers to discuss updates, quality recognition and review opportunities for improvement. Managed billing files and records for clients and adhered to safety procedures to prevent breaches and data misuse. Interacted with physicians, hospital billing departments and assistants, professionally by phone, email or via fax to supply information. Helped employees with day-to-day work and complex problems by applying motivational and analytical strategies. Choose diagnosis and procedure codes via Kareo medical billing systems. Received and sent billing statements via Practice Suite. Reviewed claims to make sure coding was correct. Monitored both inbound and/or outbound calls via Avaya of all agents daily. Randomly sampled medical billing claims for quality. Maintained and updated information about coding, insurance carriers, managed care networks and credentialing in an organized easy to reference format. Supplied reports, analysis and offered recommendations on how to improve the customer experience or drive operational efficiencies. Proactively found training opportunities and supplied recommended solutions to enhance the overall interaction of inbound caller experience. Enforced company contracted SLA's (Service Level Agreement). Delivered KPIs (Key Performance Indicators) of inbound agents which included average handling time, agent occupancy, call transfer rate, people management, productivity, compliance parameters, quality, customer satisfaction Pharmaceutical Customer Care
• Pharmaceutical Customer Care Representative, Merck & Company, Rahway, NJ, 1995-01-01, 2011-12-31, Administered and kept vendor data while supplying prompt and correct responses to both internal and external customers. Aided with invoicing of custom-built software for modeling research. Supplied a high-level of administrative support including a variety of projects support by leading and executing events including poster board sessions and meetings and managing all information requests and receiving visitors. Processed international Purchase Orders, Created Requisitions, Monthly Service Agreements, and Extended Warranties via IProcurement/ SAP. Supported the Sales Team by keeping vendor invoices, records of Research and Development team promotions, poster board sessions, sales price changes, all factors affecting vendor billing. Immediately resolved all problems while ensuring the provision of high-level customer service and customer satisfaction. Supplied primary coverage for customer service phones daily. Maintained department personnel records, tracking vacation and personal time via PeopleSoft Time & Labor Systems. Performed job duties in a way that met or exceeded individual performance metrics in support of exceptional customer experience. Managed front-line inquiry/service complaint management and escalated unresolved calls to appropriate subject matter experts based on SOP (Standard Operating Procedures). As a Pharmaceutical Customer Care Representative: Responsible for responding to incoming rejected pharmacy and patient prescription inquiry calls. Logged all calls taken daily and tracked the caller's information i.e., type of call, and what - actions were taken to aid the customer for trend analysis. Replied to pharmacy and patient inquiries via email in an exact and prompt manner. Created and kept all pharmacy and patient Incident and Discrepancy Reports. Provided customers with a solution, processing any credits, rebills or vacation overrides if necessary.

Managing and leading a team of customer service representatives, providing training, and coaching to ensure high-quality service. Monitoring team performance, setting customer service metrics, and analyzing data to inform service improvements.