Summary
Work History
Education
Skills
Certification
Timeline
CustomerServiceRepresentative
Tonya Troy

Tonya Troy

South Fork,PA

Summary

Quality assurance professional with a robust background in auditing and compliance, complemented by extensive experience as a Call Center Customer Service Representative. Dedicated to delivering courteous, prompt, and detailed support while effectively managing outbound and inbound calls in high-pressure situations. Recognized for enhancing operational efficiency and ensuring strict adherence to quality standards. Highly collaborative and adaptable to evolving requirements, consistently focused on providing reliable and accurate results.

Work History

Bakery Worker/Cake Decorator (Seasonal Position)

Custom Cakes & Cookies
Johnstown, PA
10.2025 - 01.2026
  • Operated baking equipment for consistent product quality and adherence to safety standards.
  • Maintained cleanliness of workstations and compliance with health regulations to ensure food safety standards were met.
  • Prepared and measured ingredients according to recipes, ensuring accurate proportions for various baked goods.
  • Monitored oven temperatures and baking times to optimize product texture and flavor profiles.
  • Demonstrated versatility within the role by performing various tasks such as decorating cakes, preparing doughs, mixing batters, and baking pastries as required for business needs.

Quality Assurance Auditor

Centene/Health Net Federal Services
Johnstown, PA
01.2018 - 12.2024
  • Conducted comprehensive audits of healthcare documentation and verbal information provided for compliance with regulatory standards.
  • Trained staff on best practices in quality assurance methodologies and compliance requirements.
  • Reviewed work instructions and production strategies to verify compliance with established standards.
  • Created and managed Excel Spreadsheets for the quality department, in order to efficiently and consistently perform duties.
  • Maintained a strong knowledge of HIPAA regulations to ensure compliance with all applicable standards.
  • Met or exceeded all department metrics for the year 2024.

Customer Service Representative

Health Net Federal Services
Johnstown, PA
05.2016 - 01.2018
  • Delivered exceptional customer service by resolving inquiries and issues efficiently.
  • Assisted clients with enrollment processes, ensuring accurate information capture and compliance.
  • Managed complex case resolutions, maintaining high standards of accuracy and client satisfaction.
  • Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
  • Managed multiple communication channels, including phone, email, and chat, maintaining quality service standards.
  • Assisted customers in navigating company website to locate and update information, improving overall user experience.
  • Provided coaching and mentoring to new hires, contributing to their successful integration into the team.
  • Exceeded performance metrics consistently, earning recognition as a top performer within the team.
  • Entered and maintained accurate data records in company databases.

Education

No Degree - Mathematics Education

University of Pittsburgh At Johnstown
Johnstown, PA

High School Diploma -

Forest Hills School District
Sidman, PA
05-1995

Skills

  • Skilled in Microsoft Word, Microsoft Teams
  • Proficient in Excell
  • Quality control processes
  • Document analysis
  • Process implementation & time management abilities
  • HIPAA Compliance requirements
  • Lean Six Sigma methodology
  • Strong attention to detail
  • Strong multitasking skills
  • Strong written and verbal communication
  • Efficient organization
  • Skilled in payment and account handling

Certification

  • LEAN SIX SIGMA- Yellow Belt- CERTIFIED 2023
  • SERVSAFE CERTIFICATION- 2013
  • FEDERAL CLEARANCE - DEPARTMENT OF DEFENSE (DOD) NATIONAL AGENCY CHECK - 2016

Timeline

Bakery Worker/Cake Decorator (Seasonal Position)

Custom Cakes & Cookies
10.2025 - 01.2026

Quality Assurance Auditor

Centene/Health Net Federal Services
01.2018 - 12.2024

Customer Service Representative

Health Net Federal Services
05.2016 - 01.2018

No Degree - Mathematics Education

University of Pittsburgh At Johnstown

High School Diploma -

Forest Hills School District

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Tonya Troy