Management, Customer Service, Credit / Debit Card Experience
Resume:
Willard Augustus Kingsbury III
**** ***** ******* *****. **** C. Tempe, Arizona 85283
*******.************@*****.***
Objective
Secure a position in which my positive attitude, leadership experience, communication skills, and ability to rapidly analyze and resolve difficult situations can be applied to add value and strength to the organization.
Qualifications
• Seven years of supervisory related experience.
• Nineteen years of customer service experience.
• Eight years of analyst and issue resolution experience. Professional Experience
Grievance Med D Senior Consultant – CVS Health – Scottsdale, Arizona – January, 2017 to June, 2017
Review multiple Grievance consultant’s processed cases of investigated account issues and / or member concerns as identified in a formal Grievance to provide closure approval in accordance with the Centers for Medicare and Medicaid Services (CMS) guidance and standard operating procedures.
Closely worked with Grievance consultants to meet or exceed the CMS imposed timeliness for case management and issue resolutions while maintaining compliance with the quality standards for all related work activities (i.e., turnaround time, productivity and quality expectations).
Maintain and share subject matter expertise of relevant and changing Med D guidance for complaint / grievance case management and to develop internal processes that improve workflow efficiency.
Provide training, guidance and feedback to develop colleagues and ensure a pipeline of talent for the future.
Worked closely with Senior Leadership on Grievance consultant feedback and to develop new internal operating procedures.
Utilize multiple systems related to pharmacy benefit management and medical record keeping such as MARx (the CMS system), Health Plan Management System (HPMS), RxCLAIM online claim processing system, Valencia system for CMS communication via Transaction Reply Codes
(TRC), TriZetto FACETS for claims adjudication, billing, enrollment, eligibility and more, as well as other systems for all related work activities.
Grievance Med D Supervisor – CVS Health – Scottsdale, Arizona – May, 2016 to January, 2017
Engage, inspire and develop 14 direct reports to exceed weekly and monthly Grievance casework expectations by instilling a sense of urgency, energy and excitement which fosters pride in colleagues to fulfill the organization’s purpose and drive issues to closure.
Build a high-performing team by creating an environment where team members have the opportunity and freedom to perform at their best in addition to recognizing colleagues who deliver results and demonstrate the organization’s values.
Provide opportunities, guidance and feedback to develop colleagues and ensure a pipeline of talent for the future.
Maintain performance momentum in team members by continually recognizing and celebrating short-term wins and shared successes.
Make timely and well-informed fact-based decisions that balance analytic insights with personal experience.
Manage through ambiguity and complexity to take calculated risks to solve problems, forge new paths for growth and achieve challenging goals.
Rapidly adjust strategies and priorities to meet changing business requirements. CTM Med D Senior Consultant – CVS Health – Scottsdale, Arizona – July, 2015 to May, 2016
Process, resolve, and respond to account issues and / or member concerns as identified in a formal Complaint Tracking Module (CTM) or Grievance, in accordance with CMS guidance and standard operating procedures.
Meet or exceed the CMS imposed timeliness for case management and issue resolutions while maintaining compliance with the quality standards for all related work activities (i.e., turnaround time, productivity and quality expectations).
Maintain knowledge of relevant and changing Med D guidance for complaint / grievance case management.
Utilize multiple systems related to pharmacy benefit management and medical record keeping such as MARx (the CMS system), Health Plan Management System (HPMS), RxCLAIM online claim processing system, Valencia system for CMS communication via Transaction Reply Codes
(TRC), TriZetto FACETS for claims adjudication, billing, enrollment, eligibility and more, as well as other systems for all related work activities.
Grievances Med D Senior Coordinator – CVS Health – Scottsdale, Arizona – November, 2014 to July, 2015
Analyze data, generate screenshot documents, legal writing research and professional writing resolution letters to determine conclusions and resolve complex escalated complaint cases from SilverScript Insurance Company’s Medicare Part D beneficiaries.
Maintain knowledge of relevant and changing Medicare Part D guidelines for complaint/grievance case management, productivity and quality expectations within accordance to CMS guidance and CVS / Caremark standard operating procedures.
Utilize effective time-management to ensure workflow efficiency that meets and exceeds management’s expectations and CMS imposed timelines for issue resolutions while maintaining compliance with the quality standards for all related work activities.
Utilize multiple systems related to pharmacy benefit management and medical record keeping such as MARx (the CMS system), Health Plan Management System (HPMS), RxCLAIM online claim processing system, Valencia system for CMS communication via Transaction Reply Codes
(TRC), TriZetto FACETS for claims adjudication, billing, enrollment, eligibility and more, as well as other systems for all related work activities.
Card Services Team Lead / Supervisor Stretch - Fiserv - Phoenix, Arizona - July, 2013 to November, 2014
Resolve complex client escalated calls, issues, and concerns.
Assume responsibility as supervisor on duty in the absence of card department management.
Provide support to approximately 40 associates on procedural questions, scheduling issues and line of business changes.
Utilize real time systems to monitor associate call production and inbound call queues. Freelance Graphic Design / General Artist - Artistic Industries - July, 2011 - July, 2013
Utilized self-management to ensure client orders were processed within expected time frames.
Facilitated and maintained public relations events to promote services offered.
Controlled workflow processes to maximize production of artwork for timely completion. Assist Center Analyst - MFS Investment Management - November, 2005 - July, 2011
Provided technical support to approximately 60 call center associates over a dedicated help line.
Administered employee developmental feedback and coaching when applicable.
Organized a company-wide Assist Center presentation with job aides to strengthen the issue escalation workflow process.
Resolve complex client escalated calls, issues, and concerns. Education
Dale Carnegie Institute – Tempe, Arizona – Skills for Success Mesa Community College - Mesa, Arizona - Business Management East Valley Institute of Technology - Mesa, Arizona – Graphic Design / Commercial Art Professional references available upon request
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