TONYA M. NELSON-WALKER
Virginia Beach,Virginia
Summary
Dynamic professional with extensive experience at United Health Group, excelling in critical thinking and complex problem-solving. Proven track record in enhancing customer satisfaction through active listening and effective communication. A dependable team player, adept at managing high-volume inquiries while maintaining compliance with regulations and policies.
Overview
16
16
years of professional experience
Work History
Complex Customer Care Representative Sr.
United Health Group/United HealthCare
07.2023 - Current
- Plan, prioritize, organize and complete work to meet established objectives for our families
- Responsible for managing project time to insure follow up and outreach work is completed in a timely manner
- Responsible for maintaining accurate family counts on our documentation platform
- Focus on teamwork and fostering a strong team environment through activities including mentoring and acting as a resource for colleagues
- Make decisions independently and solve problems creatively and completely using sound judgment and critical thinking
- Handle resolution/inquiries from members and/or providers
- Access electronic member files using policy or id number
- Maintain Confidentially and adhere to HIPAA Requirements
- Performs other duties as assigned
Associate Clinical Administrative Coordinator
United Health Group/Optum
03.2022 - 07.2023
- Manage inbound and outbound telephone communication in a professional manner and according to productivity and quality standards
- Speaks clearly and persuasively in positive or negative situations; listens and seeks clarification; responds openly to questions
- Process inbound and outbound data and communication
- Enter, review and or verify member information
- Follow chain of command as appropriate when reporting issues or concerns
- Promote a positive attitude and work environment
- Assist member with complaints and escalated issues to assure the appropriate action for resolution occurs
- Manages difficult or emotional customer situations; responds promptly to customer needs; solicits customer feedback to improve service; responds to requests for service and assistance; meets commitments
Customer Service Agent
TTEC
06.2020 - 01.2022
- Reviewed clients' health care plan and evaluated their needs and coverage they are eligible to receive
- Made recommendations about obtaining supplemental insurance and help people understand their options for prescription drug, vision, and dental policies
- Received inbound calls from clients
Office Manager
Old Dominion University
Norfolk, Virginia
03.2018 - 02.2020
- Served as sole administrative support for the Director of the Leadership and Student Involvement office, Associate Directors, Coordinator for Activities and Programs, Coordinator for Student Organizations, and Coordinator for Community Service
- Hired, trained, and supervised student office assistants to ensure that the goals and objectives, productivity and quality standards are met
- The processing and approval of schedule exceptions, including vacation requests, based on forecasted requirements
- Report, track and update staff attendance performance
- Coordinated, supervised and was accountable for daily activities of business support, technical or production team or unit
- Completed payroll reports for Human Resources and Career Management services for work-study student workers
- Conferred with organizations officials, and staff members to discuss issues, coordinate activities, or resolve problems
- Assisted with on-line student organizations’ registration and re-registration
- Coordinated security needs for student organizations’ and the Leadership and Student Involvement campus events
- Knowledgeable of the university policies and procedures regarding travel, payroll, scheduling and budgeting
- Recommended new or revise methods to changes in regulations to improve efficiency
- Attended applicable meetings and conferences to analyze services provided by the office
- Resolved calls, avoiding escalated complaints
Education Support Specialist III & II
Old Dominion University
Norfolk, Virginia
07.2009 - 03.2018
- Used computers for various applications, such as database management or word processing
- Set up and managed paper or electronic filing systems, recording information, updating paperwork, or maintaining documents, such as attendance, correspondence, or other material
- Greeted visitors or callers and handled their inquiries or direct them to the appropriate persons according to their needs
- Completed forms in accordance with company procedures
- Scheduled and confirmed appointments for students and parents
- Utilized state benefits eligibility computer systems
- Provided excellent Customer Service in a high-volume environment
- Provided exceptional customer service to internal and external customers
- Adhered to Regulatory/ Guidelines and policies & procedures
Education
Masters - Human Services
Walden University
Minneapolis, MN08.2018
B.A. - African-American Studies
University of Cincinnati
Cincinnati, OH05.2001
Associate of Liberal Arts -
University of Cincinnati
Cincinnati, OH05.1995
Skills
- Critical Thinking Skills
- Complex problem solving
- Active Listener
- Dependability
- Team player
- Interpersonal skills
- Customer and Personal Service
- Time management
Additional Information
- State of Virginia Registration: Quality Mental Health Professional- Trainee (QMHP-T), 2020 - 2025
- Old Dominion University: Certificate of Completion, Quality Service Professional, Noel Levitz Quality Service Program for Higher Education, 2009
- Associate Practitioner of the Leadership & Management Development Certificate Program. Track I, 07/11
- Program Practitioner of the Leadership & Management Development Certificate Program. Track II, 07/12
- Senior Management Practitioner of the Leadership & Management Development Certificate. Track III, 07/13
- Leadership & Management Development Certificate Program Track IV, 05/15
- Member, Student Engagement & Enrollment Services Recognition Committee, 2012
- First – Time Manager or Supervisor Seminar Certificate 0.6 CEU & CPE Credits, 2018
- Microsoft Excel Basics CEU:0.6 CPE:6 PDU:6, 2019
- Microsoft Excel Beyond the Basics CEU:0.6 CPE 6 PDU:6, 2019
- State of Virginia: Insurance Producer: Health, 1190669
- CARE Support Team Mentor, 04/24, present, Conducts weekly support sessions with new hire employees.
- Close Loop Champ, 08/24, present
Timeline
Complex Customer Care Representative Sr.
United Health Group/United HealthCare
07.2023 - Current
Associate Clinical Administrative Coordinator
United Health Group/Optum
03.2022 - 07.2023
Customer Service Agent
TTEC
06.2020 - 01.2022
Office Manager
Old Dominion University
03.2018 - 02.2020
Education Support Specialist III & II
Old Dominion University
07.2009 - 03.2018
Masters - Human Services
Walden University
B.A. - African-American Studies
University of Cincinnati
Associate of Liberal Arts -
University of Cincinnati
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