Customer Service Manager

Mollie A. McAleer

**** *. ******** **.

Mesa, Arizona 85205

Cell Phone: 480-***-****

Email: abloup@r.postjobfree.com

SUMMARY OF QUALIFICATIONS:

Senior level issue resolution

Senior level knowledge of medical and dental insurance claims/benefits

Analytical experience in high volume on line telephone customer service

Exceptional oral and written communication proficiency; attention to detail,

ability to multitask, strong organizational skills

EXPERIENCE:

April ’04 – Jan. '10 - SCHALLER ANDERSON/AETNA – Phoenix, Az.

Quality Review Monitor

Responsible for assisting with calls when high volume,or short staffed, plus 8 hours per week to

maintain knowledge of all types of calls received. Monitor call quality of provider collection

calls for seven plans, both AHCCS and commercial, according to department standards. Score

and document results for each monitored call. Maintain on-going communication process with

supervisors regarding quality of monitored calls. Provide training to new representatives and for

representatives who are not meeting the standards. Develop, establish and maintain a work

priority system to insure daily and heavy workloads are fulfilled. Provide management with

monthly reports. Maintain strict confidentiality in regards to all employees, members, providers

and contract service information. Consistent over 125% production level. Two hours per day

audit over $50,000 claims for accuracy.

Nov. 03 – April ‘04 - SCF OF ARIZONA (WORKMANS’ COMPENSATION) – Phoenix,

Az.

Underwriter/Policy Writer/Customer Service

Responsible for high volume servicing of accounts, rendering service of existing policies,

approval and writing of new policies for employers, interview walk-in prospective policyholders,

computation of premiums, calculating quarterly/annual reports, recitation of Workers’

Compensation laws, rules, and regulations, familiarization with NCCI classification codes.

Feb. ’02 – Nov. ’03 – CLAIMS ADMINISTRATION CORPORATION – Mesa, Az. (No

longer in business)

Customer Relations Associate

Responsible for the resolution of issues regarding benefits, prescriptions, prescription pricing,

pre- cert approvals, claims, and appeals for a federal government funded health and dental

insurance plan. Written and oral communication with members, providers, and insurance

corporations. Reprocessing and adjustment of claims processed incorrectly.

Sept. ’99 – Nov. ’01 – CNA UNISOURCE – Phoenix, Az. (No longer in business)

Account Service Manager

Responsible for set up of new client accounts, client orientations, payroll conversions, employee

benefit and payroll orientations. Continuous service maintenance of approximately 65 clients

throughout Arizona, Washington, Idaho, Montana, and Oregon. Close working relationship with

two customer service representatives to insure the highest quality of service. Seventy-five

percent travel.

EDUCATION:

Felician College, Chicago, Il.

Two years of Accounting

American Express Travel School, Phoenix, Az.

Certified Travel Counselor

Phoenix Community College, Phoenix, Az.

Certified Emergency Communicator

ASU Law School, Tempe, Az.

Certified Superior Court Mediator

Certification Dean Vaughn Medical Terminology

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