Customer Service Manager
Resume:
Karima Coke
**** ** ***** ****** . ***** Miami Beach, FL 33179 . 954-***-****
Success Driven HealthCare Professional
A results oriented professional with 12 years of broad-based management
experience in health plan and call center operations. Decisive leader with
proven success in strategic planning and implementation of initiatives to
support new business opportunities. Customer focused and performance
driven. Excels in business planning, and establishing policies, process and
performance monitoring systems to support continuous improvement. Critical
thinker who can apply extensive knowledge of industry and government
regulations to direct resources.
. People Soft
. Proven ability to lead effective teams
. Customer Relationship Management
. Process & Performance Improvement
. Employment Law
. Quality Improvement
. Negotiating/Bidding Large Government Contractors . CPR
certified
Equal strengths in delivering large scale projects ahead of schedule and
under budget. Possess solid knowledge of Federal Acquisition Requirements
(FAR), Medicare policies and regulations and CMS guidelines and
regulations.
Key Achievements
Professional Experience
Employee Benefits Manager, Aetna, FL
(Feb 06-Present)
. Ensure company compliance with federal and state laws, including
reporting requirements.
. Evaluate job positions, determining classification, exempt or non-
exempt status, and salary.
. Plan, develop, evaluate, improve, and communicate methods and
techniques for selecting, promoting, compensating, evaluating, and
training workers.
. Prepare occupational classifications, job descriptions and salary
scales.
. Advise managers on organizational policy matters such as equal
employment opportunity and sexual harassment, and recommend needed
changes.
. Advise managers and employees on state and federal employment
regulations, collective agreements, benefit and compensation policies,
personnel procedures and classification programs.
. Conduct ongoing review and analysis of performance results, goals and
projections to continually improve efficiencies while resolving
escalated barriers/issues.
. Administer compensation, benefits and performance management systems,
and safety and recreation programs.
. Represent organization at personnel-related hearings and
investigations.
. Observe, interview, and survey employees and conduct focus group
meetings to collect job, organizational, and occupational information.
. Plan, direct, supervise, and coordinate work activities of
subordinates and staff relating to employment, compensation, labor
relations, and employee relations.
. Identify staff vacancies and recruit, interview and select applicants.
. Plan and conduct new employee orientation to foster positive attitude
toward organizational objectives.
. Perform difficult staffing duties, including dealing with
understaffing, refereeing disputes, firing employees, and administering
disciplinary procedures.
. Analyze and modify compensation and benefits policies to establish
competitive programs and ensure compliance with legal requirements.
. Serve as a link between management and employees by handling questions,
interpreting and administering contracts and helping resolve work-
related problems.
Karima Coke
1680 NE 191st . North Miami Beach, FL 33179 . 954-***-****
Aetna, Plantation, FL
Team Manager (2000-2006)
. Provided leadership and direction to a workforce of 50-60 employees to
include phone collection staff.
. Developed, implemented and monitored training programs.
. Responsible for organizing, developing, counseling, and motivating
employees.
. Developed marketing concepts and alternatives.
. Suggested new products that increased earnings by 18%.
. Increased sales of health insurance products by 20%.
. Post daily receipts and maintain all business financials, accounts
receivables and payables.
. Developed standard operating procedures for all facets of operation.
.
HIP Administrators, Hollywood, FL
Manager, Member and Provider Customer Service Operations (1997-2000)
. Provide leadership and coaching to temporary and permanent call center
staff to enable the team to meet or exceed performance goals and
customer expectations while building a high performing, culturally
diverse team.
. Analyze quality and production statistics with critical success factors
to include the reinforcement of the C.O.R.E. program while gauging team
and call center focus and needs. Participate in quarterly calibration
sessions to ensure effective and consistent communication occurs.
. Lead multi-functional problem solving efforts; create an analysis
framework; and present recommendations for viable solutions in project
level work.
. Build and maintain collaborative relationships through organization to
ensure facilitation and resolution of member and provider issues to
include Claims, Enrollment, Billing and Grievance and Appeals
. Conduct ongoing review and analysis of performance results, goals and
projections to continually improve efficiencies while resolving
escalated barriers/issues.
Education/Credentials
Barry University, FL BS Health Administration
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