| | | 20,000+ Fresh Resumes Monthly | |
|
|
| |
Click here or scroll down to respond to this candidate Candidate's Name
Street Address Braddock Run RoadWhite Marsh, Maryland Street Address
Day Phone: PHONE NUMBER AVAILABLEObjective: To secure an entry level management position within a health care organization that will utilize my 37 years of experience in telephony and healthcare customer service, operational compliance and education.Summary of QualificationsThirty -seven (37) years' experience in internal and external client management, customer billing and project management. Direct Customer Sales Revenue Projection and Generation National Account Billing Management Claims and Billing Processing Staff Development and Training Operations Compliance Reviewer InvoicingProfessional Experience:MAXIMUS (DCAS) Call Center Supervisor Dec. 2021 PresentManaged a team of an average of 20 DHS Call Center Representatives responsible for responding to all incoming calls regarding TANF, SNAP, and Medical Assistance for District of Columbia Residents.Trained staff to equip them complete client service transactions, input and maintain client information, and process all other client transactions while maintaining SLA contractual obligations.Operate team in a high volume, metrics-driven while keeping the moral in an virtual environment to support the contractual needs of the call center.Quality Auditor Call Center Quality Assurance Auditor monitor and measures the quality of inbound and or outbound customer service calls. Prepares and presents audit reports for the Customer Service Representative to identify the issues and performances. The calls were processed by QEval. QEval is an innovative Assurance Software Systems.ETech Weekly Call Volume Deliverable Etech, provides call quality monitoring service that verified and track the inbound and outbound on web base.Maximus Attendance Report Deliverable The report will allow the ability to identify absenteeism. Tracking absences help employers identify patterns of absenteeism and take correction action, keep the CSRs engaged, minimize dropouts and increase the CSRs success.MAXIMUS Federal, Woodlawn MarylandProgram Integrity Assurance Reviewer/Invoicing Aug. 2019 Dec. 2021
The (PIA) Initial Reviewer will applications, invoices, and supporting documentation for eligibility determination according to Program rules and guidelines. Conducts reviews of applications submitted by schools and libraries for discounts for internet access, internal connections, basic maintenance of internal connections, and managed internal broadband services and equipment received for eligibility. Processes invoices for discounts on equipment and services. Communicates with applicants through email, E-Rate Systems and by telephone to obtain the required documentation required to process applications. Utilizes desktop procedures, checklists, and other documentation to process applications and invoices. Perform quality reviews of applications and invoices when required to ensure accuracy. Escalates issues and questions as they arise when processing Program documents.Maryland Benefit Exchange (MHBE) Call Center/MAXIMUS, Woodlawn, MarylandCall Center Supervisor Dec. 2019 - PresentResponsible for supporting, managing and monitoring twenty-five (25) Customer Service Representatives. Monitoring the call center agent performance in direct relation to established call center metricd and established contractual Service Level Agreements. Identified training and developmental opportunites for Consolidate Service Center (CSC) staff. Monitored work assignment loads while coordinating schedules and work group skilling as requested by Work Force Management (WFM) personnel. Responsible for day to day application of Maximus and Maryland Health Benefit Exchange policies and procedures. Provided appropriate oversight to ensure CSC agents remain abreast of newly developed process flows, policies and procedures. Determined operational objectives by analyzing business functions, evaluating output requirements and formats. Monitored project progression by tracking activity, resolved employee concerns, published progress reports and recommended appropriate corrective action for adverse employee events.
Call Center Team Lead Oct. 2019 - Nov. 2019Responsible for retrieving, reviewing, verifying, collecting, recording, updating the consumer's contact information and relevant data via Oracle Client Relationship Management (CRM) application. Educate the callers and enrollees about the Affordable Care Act (ACA), Maryland Health Benefit Exchange (MHBE) call center eligibility screening, Maryland Health Connection (MHC) application inquiry, complaints, claims, exemption and appeals. Provide the consumers with information regarding the initial eligibility determinations. Provided techinical assistance and direct the callers through the web portal plan comparison steps. Referred the consumers to Brokers, Navigators, Community Assistance Workers, Connector Entity staff or other consumer support representatives with an array of eligibility and enrollment issues. To maintain up-to-date knowledge of all MHC QHP and Medicaid program information, policies and procedures. Possessed strong knowledge of Medicaid Management Information Systems (MMIS) and Security Identity manager systems.Customer Support Representative (CSR) Nov. 2016 - Sept. 2019 Educate Maryland residents about the Affordable Care Act and programs specific to the State of Maryland residents; Follow all state and federally mandated HIPPAA guidelines; Screen and assist Maryland residents with application updates and corrections; Answer inquiries regarding Maryland eligibility and exemption policies; Assist consumers with plan shopping and healthcare plan comparisons; Retrieve, review, verify, collect, record or update the customer contact infomation an data through the Salesforce Customer Relationship Manager (CRM); Refer consumers to external Consumer Assistance Workers (CAW), if applicable; Assist external Customer Assistance Worker (CAW) with inquiries regarding eligibility and enrollment.CareFirst BlueCross and BlueShield, Ownings Mills, MDCorrespondence Analyst III Jan. 2011 - Oct. 2016 Respond to Healthcare Providers and Member inquiries in inbound and outbound call center environment; Process Member correspondence via secured web services and US Mail.Correspondence Customer Service Representative II & III Sept. 2003 - Jan. 2011 Respond to Healthcare Provider and Member inquiries in inbound and outbound call center environment; Efficient and accurate handling of incoming calls from doctors and hospitals related to the claim status and benefit information. Manage time to ensure that incoming calls and written inquiries are answered within the required service level metrics; Process entry level to intermediate claims and assist Special Projects team with production case inventory; Manage Central Appeals and Medical Review inventory.Customer Service Representative I Aug. 2002 - Sept. 2003 Analyze Consumer contracts and asset business need based on current product offering; Developed service techniuques and technical competencies for the purpose of maximizing customer retention, satisfaction, and potential financial savings. Respond to telephone inquiries, written inquries, and automated inquiries, on-demand payments from subsribers, group administrators, providers, brokers, medical professionals, internal staff, which included the Individuals Marketing Department (IMD).CareFirst BlueCross and BlueShield, Ownings Mills, MD May 2002 - Aug. 2002Patuxent Group - Imaging Operations (IOS) - Data Entry Comprehensive data entry on alpha and numeric keyboard with emphasis on accuracy and speed development on systems BCIQ, PV40, PVXI, PVEX, and TCAR.AT&T Communications, Hunt Valley, MD
Assistant Billng Manager, AT&T Jan. 2000 - May 2002 Manage and develop a group of twenty (20) Global and Middle Market CSSS's whose job function included:
* order processing * billing disputes and resolution * collections Create and deliver in-house training for staff development Provide team and individual coaching and feedback to ensure superior job performance Accountable for all Call Center service level metrics with focused on improvements in CVA, BVA and PVA.AT&T Communications, Hunt Valley, MD
Customer Sales and Service Specialist Jan. 1996 - Jan. 2000Business Inquiry Representative Jan. 1989 - Jan. 1996Account Representative Jan. 1986 - Jan. 1989 Mastered the lastest computer technology for use in the resolution of billing and collection issues. Ordered Outbound/Inbound long distances services, and Data Lines for Global business customers. Maintained designated accounts with a revenue base of approximagely $5,000,000.00. Educated customers by answering billing questions and giving detailed explanation of service provided.Computer Input Service, Baltimore, MDData Entry/Word Processor Operator Jun. 1980 - Jan. 1986 Comprehensive data entry training on alpha and numeric keyboard with emphasis on accuracy and speed development. Familiar wih record layouts, column and file identification, EDP terminology, upper and lower case, abbreviation recognition: experience in jobs (microfiche voucher). Completed utilizing skills key to disc, IBM 129, Decisin Data 8010 and Entrex 600.Education:Phoenix University, Minneapolis, MinnesotaPursuing a Bachelor's Degree in Business Administration
3 years completed.Mid-Atlantic Christian College, Baltimore MarylandBachelor's Degree in Biblial StudiesCertificate and Trainin Courses:Interpersonal Communications, Peer Mediation and Conflict Resolution, Conflict Managment, Time Management and Team Facilitation.Computer Skills:Microsoft OfficeVisioPEGA SystemFACETSTrizettoReferences:References: Will be furnished upon request. |
