TRACI DIAMOND-MCLEAN
Lumberton,NC
Summary
Customer Service Representative with extensive experience in benefit management and HIPAA compliance. Demonstrated effectiveness in resolving inquiries and enhancing participant satisfaction through efficient communication and collaboration with healthcare teams.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Care Coordinator 1
One Call
10.2025 - 05.2026
- Provided customer support by phone, email or instant messaging to business customers. Serves as primary contact for inbound customers issues. Escalates more technical product-related issues to the proper Product Support Department
- Processes a high volume of customer inquiries of One Call Care Management products and services and resolves a targeted percentages of those inquiries
- Troubleshoots customer problems, identifies the root cause of the problem and uses tools and resources appropriately to determine how to resolve customers problems
- Tracks and documents inbound support requests and ensure proper notation of customer problems or issues
- Updates customer information and ensures accurate entry of contact information
- Provided guidance and/or mentoring to less experienced Customer Service Associates
- Met the standards of quality, adherence to schedule and average handle time
- Coordinated patient care services to ensure seamless healthcare delivery.
- Managed scheduling and transportation logistics for patient appointments.
- Liaised with healthcare providers to facilitate effective communication among teams.
- Developed care plans tailored to individual patient needs and preferences.
- Monitored patient progress and adjusted care strategies as necessary.
- Educated patients and families on treatment options and resources available.
- Collaborated with multidisciplinary teams to optimize patient outcomes.
- Maintained accurate records in electronic health systems for compliance and tracking.
- Maintained accurate client records in accordance with agency policies and procedures.
- Collaborated with physicians, social workers, and other healthcare providers to provide comprehensive care for patients.
- Responded promptly to inquiries from patients regarding their care plans.
- Provided case management services to ensure the delivery of quality care.
Remote Customer Care Representative
Qualfon Data Services - Delta Dental
11.2022 - 09.2025
- Resolve dental claims, ensuring accuracy and high satisfaction.
- Manage communications, sharing plan details with providers and participants.
- Use Meta Vance for payment explanations, enhancing satisfaction.
- Maintain service standards by multitasking process payments and updating records.
- Address billing issues promptly, contributing to improved customer service.
- Resolved complex dental claims inquiries with precision, ensuring accurate information delivery and maintaining high customer satisfaction levels.
- Leveraged Meta Vance system to provide clear payment explanations, reducing follow-up inquiries and enhancing overall participant satisfaction.
- Partnered with interdepartmental teams to resolve escalated billing issues, creating seamless customer experiences through coordinated problem-solving.
- Translated technical dental coverage details into actionable information, empowering customers to make confident benefit decisions.
- Identified and documented billing discrepancies while tracking provider payments, facilitating timely resolutions that improved client satisfaction rates.
- Processed complex dental claims with precision in Meta Vance, reducing follow-up inquiries while maintaining exceptional customer satisfaction levels.
Subject Matter Expert (SME)
Sutherland Global
10.2021 - 10.2022
- Addressed diverse customer inquiries, including service activation, billing disputes, and energy conservation consultations, ensuring comprehensive follow-up and satisfaction tracking.
- Improved customer service operations by identifying and recommending process enhancements, which aimed at reducing negative customer experiences.
- Interpreted company policies to provide informed responses to service-related inquiries, maintaining adherence to ACW/AHT standards and quality guidelines.
Trainee Credit Manager
Farmer's Furniture
Dublin, GA
08.2019 - 11.2019
- Managed delinquent account communications, dispatched payment reminders, and negotiated with clients to maintain account health effectively.
- Collaborated with the Credit Manager to strategize and execute collection plans for severely delinquent accounts, including direct customer visits and coordination of merchandise repossessions.
Intake Center Receptionist
IEM, Inc.
Bladen, NC
09.2018 - 05.2019
- Managed front-office operations by efficiently scheduling and confirming appointments using Appointment Plus and supported intake specialists through precise scanning and coding of documentation.
- Maintained strict confidentiality standards, safeguarding Personally Identifiable Information (PII), while consistently delivering exceptional customer service to homeowners.
Customer Service Representative
Blanton's Air, Plumbing and Electric
Fayetteville, NC
04.2018 - 08.2018
- Facilitated case management and quality control processes, while maintaining office inventory and utilizing Salesforce and SharePoint to improve operational efficiency.
- Converted customer inquiries into scheduled service appointments through effective communication, ensuring alignment with brand standards.
Administrative Assistant
YS Talent Temporary Solutions
Lumberton, NC
01.2018 - 03.2018
- Resolved customer issues promptly, fostered strong relationships to enhance customer retention, and participated in specialized training to improve call conversion rates.
- Managed administrative tasks including report preparation, data entry, and document management, ensuring efficient office operations and meticulous record-keeping.
Shipping/Receiving/Data Entry Clerk
DEC 9/Staffing Alliance Temporary Solutions, LLC
Fayetteville, NC
01.2017 - 09.2017
- Managed incoming communications, coordinated appointments, and greeted visitors, enhancing office organization and creating a welcoming environment.
- Administered and updated critical databases, including health and safety guidelines, ensuring compliance with regulatory standards and accurate financial record management.
Retail Sales Associate/Customer Service Representative
Burkes Outlet
08.2016 - 01.2017
- Delivered high-quality service and sales support, enhancing customer satisfaction and ensuring efficient transaction processing at the point of sale.
Customer Service Representative
Young Blood Staffing
06.2015 - 09.2015
- Provided exceptional customer service by fostering strong relationships and ensuring prompt, accurate responses to inquiries, which enhanced client satisfaction and loyalty.
Secretary/Office Maintenance/Bonded Cashier
McCall's Supply, Inc
06.2011 - 02.2013
- Managed order processing by creating bills of lading and coordinating shipment schedules, enhancing warehouse operational efficiency.
- Utilized AS400 and Microsoft Office to generate reports and maintain records, facilitating effective communication and data management.
Education
CERTIFICATION -
United College of Business
Los Angeles , CACertificate of Technical Studies - Notary Public
Bladenboro Community College
Bladenboro, North CarolinaAssociate of Applied Science - Paralegal Studies
Anthem College Online
Phoenix, AZSkills
- Administrative
- Appointment Scheduling
- Salesforce
- Cash register
- Windows
- Customer service
- Data entry
- Computer literacy
- HIPAA
- Documentation
- Communication skills
- Microsoft Office
- Phone etiquette
- Typing
- Organizational skills
- Mac OS
- Customer Retention
- Process Improvement
- AS400
- Meta Vance
- Microsoft PowerPoint
- Conflict Resolution
- Microsoft Excel
- Quality Control
- Microsoft Word
- Computer skills
- MS Office
- Compliance
- Fair Housing regulations
- SharePoint
- Live chat
- Communication
- Problem Solving
- Technical Support
- Record Keeping
- Sales
- Time management
- Negotiation
- Office management
- Claims resolution
- Customer support
- Process documentation
- Problem solving
- Effective communication
- Cross-functional collaboration
- Attention to detail
- Adaptability
- Team collaboration
- HIPAA compliance
- Goal setting
- Workflow management
- Scheduling
- Verbal and written communication
- Documentation proficiency
- Empathy and compassion
- Policy adherence
- Clear communication
- Healthcare
Certification
- Certified Notary Public
- Driver's License
Timeline
Care Coordinator 1
One Call
10.2025 - 05.2026
Remote Customer Care Representative
Qualfon Data Services - Delta Dental
11.2022 - 09.2025
Subject Matter Expert (SME)
Sutherland Global
10.2021 - 10.2022
Trainee Credit Manager
Farmer's Furniture
08.2019 - 11.2019
Intake Center Receptionist
IEM, Inc.
09.2018 - 05.2019
Customer Service Representative
Blanton's Air, Plumbing and Electric
04.2018 - 08.2018
Administrative Assistant
YS Talent Temporary Solutions
01.2018 - 03.2018
Shipping/Receiving/Data Entry Clerk
DEC 9/Staffing Alliance Temporary Solutions, LLC
01.2017 - 09.2017
Retail Sales Associate/Customer Service Representative
Burkes Outlet
08.2016 - 01.2017
Customer Service Representative
Young Blood Staffing
06.2015 - 09.2015
Secretary/Office Maintenance/Bonded Cashier
McCall's Supply, Inc
06.2011 - 02.2013
CERTIFICATION -
United College of Business
Certificate of Technical Studies - Notary Public
Bladenboro Community College
Associate of Applied Science - Paralegal Studies
Anthem College Online