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P PHONE NUMBER AVAILABLE EEMAIL AVAILABLEhttps://www.linkedin.com/in/Candidate's Name -bStreet Address a6130/OBJECTIVEEDUCATIONCustomer/Member Services Representative promoted to Call Center Quality Assurance Auditor. Seeking career advancement in the Health Care industry, adaptability to work setting changes, available for necessary trainings, and ability to develop opportunities for coaching, training, and strategy materials.Kurt T. Shery High SchoolTorranceCaliforniaHighest GPA: 4.0KEY SKILLS LEADERSHIP COMMUNICATION(VERBAL/WRITTEN) TIME MANAGEMENT MULTITASKING PROBLEM SOLVING ATTENTION TO DETAIL ANALYTICAL THINKING TEAMWORK EMPATHYAWARDS EMPLOYEE SPOT AWARDRELATED EXERIENCEMay 2022-PresentCompany: ACCESS Specialty Animal HospitalTitle: Client Care RepresentativeMay 2022-CurrentCompany: ACCESS Specialty Emergency HospitalsTitle: Client Care RepresentativeMay 2020 April 2022Company: Imperial Health Plan of CaliforniaTitle: Member Services Representative (May 2020-March 2021) Title: Call Center Quality Assurance Auditor (April 2021-April 2022) January 2017 September 2018Company: Prospect Medical Group / Multi Department Temp ContractTitle: Pharmacy Quality Care Coordinator (January 2017-March 2017)Title: High Intensity Coordinator (April 2018-July 2018) Title: Quality Improvement Assistant (July 2018-September 2018) January 2017 March 2017Company: SCAN Health PlanTitle: Member Service AdvocateMarch 2016 June 2016Company: Molina HealthcareTitle: Member Services RepresentativeDuties include but not limited to: 1. Answers phone calls and written questions, concerns, and complaints to include, but not limited to: members, providers, health plan, insurance brokers, and hospitals in accordance with HIPAA guidelines. 2. Comply with UM, claims, and member service policy and procedures. 3. Maintain an average handled time of no more than 10 minutes 4. Maintain an average of wait time to 2 minutes or less. 5. Assist in identifying and solving member/agent needs, issues and inquiries. 6. Document accurately all inquiries in the plans databases(s). 7. Performs call monitoring and assessment of Call Center Associates for both inbound and outbound calls. 8. Participates in call calibration exercises. 9. Participates in internal listening sessions. 10. Assists Member Services Manager in providing standard weekly and monthly reporting within predetermined reporting parameters. 11. Provides regular feedback to Member Services Leadership regarding call trends or compliance issues that may arise.COMMUNICATIONWork well with others, open communication with colleagues about departmental changes, assistance with call improvements, allowing colleagues to showcase their skills in order for management to create evaluations according to skill levels, providing assistance to leadership as well as employees from all departments with suggestions.LEADERSHIPSupervisory type position for the Call Center Quality Assurance Auditor position with Imperial Health Plan due to being the only representative in such position. Leadership type role taken when necessary to assist management and supervisors due to my skillset and expertise.REFERENCESJonathan Ramirez-ACCESS Overnight Manager-(818)887-2262 Belky Argueta-ACCESS-Daytime Manager-(818)887-2262 Jorge Villacinda - Imperial Health Plan CEO Assistant (323) 636- 2890 |