Victoria McHale
Jacksonville
Summary
Customer Relationship Specialist with demonstrated expertise in building and maintaining strong colleague connections. Skilled in customer communication, problem-solving, and conflict resolution, ensuring satisfaction. Known for adaptability in ever changing environments, consistently achieving results and supporting team success.
Overview
1
1
Certification
11
11
years of professional experience
Work History
Universal Member Provider Service Contact
Florida Blue
04.2016 - 10.2019
- Executed and designed operational workflows to enhance efficiency in data management.
- Oversaw organization of follow-up calls to ensure timely resolutions.
- Conducted 54 training sessions for member website dtp 309.2 under Denice Schoonmaker. Provided timely updates to Denice for scheduling adjustments when participants were absent. Coordinated calendar invitations and conference room bookings for training sessions. Prepared training materials and handouts for each class.
- Facilitated five training sessions for CEMB under Denice Schoonmaker. Collaborated with analysts to enhance presentation materials before distribution. Coordinated scheduling and logistics for training sessions, including booking training rooms.
- Facilitated a class of sixteen for PRE- ACA training as a part of the process for Team McVeagh to become a cross functional team in all major lines of business. Before the training began, I was given a list of advocates and had to arrange a training room location, meeting invites for the advocates calendars, prepare presentations, agendas for supervisors to be aware of what information was being trained each day, and interact with supervisors to make aware of the progress of advocates from their direct team
- Spearheaded creative design of activities and posters for Customer First initiative, fostering team motivation towards exceptional customer service.
- Oversaw delegation of submissions from sales agents and service representatives to medical underwriting and relevant departments for pre-ACA plan review.
- Served as subject matter expert (SME) to validate accuracy of information provided by new trainees to members.
- Managed escalated calls regarding member issues, ensuring effective resolution as a subject matter expert.
- Reassigned teams to be able to be cross-functional in handling NSA, Small group, MCC (ACA & Pre-ACA) calls to be able to further assist members. The training consisted of knowing all BCBSF products offered, programs offered to members, policies, billing & maintenance, funding arrangements and benefit information
- Served as subject matter expert (SME) for direct team and pre-ACA training class, providing specialized knowledge and guidance.
- Facilitated small group training sessions to enhance understanding of group renewal processes for handling agent brokers and benefit administrator calls.
- Managed project tasks related to sales compensation from May to October 2019. Processed agency requests for sales payouts efficiently. Utilized Excel and relevant systems to handle inquiries from initiation to resolution. Reviewed contract details and verified active status for each submission. Compiled contract information into organized Excel spreadsheets. Communicated findings to agency owners or delegates via email regarding payment status for contracts.
Cashier/ Customer Service Specialist
Best Buy
10.2019 - Current
- Maintained money and assisted customers with returns and exchanges to improve their experience.
- Created tickets to resolve benefit discrepancies and manage multiple claims and accumulators
- Process written request for Pre-ACA plan to make changes for their coverage (i.e., Cancellations, Member deletions, banking information change, etc.)
- Responsible for maintaining money and assisting customers with returns and exchanges to better their experience
- Led back office operations as interim supervisor - Accountable for accurate sale counting and balancing register tills before the business day begins
Sale Associate/ Cashier
Dollar General
05.2015 - 10.2015
- Servicing customers with finalizing their purchases
- Customers fond of communication between the Manager on duty and me
Customer Relationship Specialist
Florida Blue
Jacksonville, FL
10.2019 - Current
- Facilitated communication and collaboration between accounts, members, providers, and other BCBS plans.
- Analyzed benefits-related issues and initiated ticket creation to address claims and accumulator errors.
- Managed written requests for pre-ACA plan adjustments to ensure accurate coverage modifications, such as cancellations and member deletions.
- Led pre-ACA training classes, ensuring comprehensive understanding of key concepts, and providing assistance during live production among attendees.
- Led coordination efforts for temporary plan enrollments through strategic partnerships with sales managers during escalation resolutions. Acted as the main point of contact for the enrollment process, facilitating effective communication.
- Served as Subject Matter Expert (SME) to provide guidance and support to team members across various team chats.
- Assisted in refining k360 procedures to ensure advocates have access to the most current information. Contacted analysts to establish accurate production expectations when new work groups were integrated into production.
Education
High School Diploma -
First Coast High School
Jacksonville, FLSkills
- Microsoft Office Suite (Outlook, Word, Excel and PowerPoint)
- ICD-9, ICD-10 and CPT Coding
- HIPAA Regulations
- Ulysses
- Diamond
- Blues Enroll
- View & pay invoices (VPI)
- Customer Connect
- Teams
- Health Plan Services (HPS)
- Problem-solving abilities
- IMA
- RBMS
- EIP
- Adaptability and flexibility
Certification
- Florida Blue Facilitator Certification program - completed April 2024
Professional Skills
- Customer Service Focus
- Communication
- Exceptional Root Cause Research Analyst
- Leadership
- Development and Training
- Process Improvement
- Computer skills
- Quality Assurance
Timeline
Customer Relationship Specialist
Florida Blue
10.2019 - Current
Cashier/ Customer Service Specialist
Best Buy
10.2019 - Current
Universal Member Provider Service Contact
Florida Blue
04.2016 - 10.2019
Sale Associate/ Cashier
Dollar General
05.2015 - 10.2015
High School Diploma -
First Coast High School