Customer Service Quality Assurance

Erica Purnell

The Bigger Picture

Laurel, MD

********@*****.*** - 443-***-****

A dedicated and focused results- oriented professional, who is accomplished in establishing and fostering

business relationships. Strengths in critical thinking and problem solving, as well as communication and time

management. Ability to multi- task and adjust priorities as necessary. Self- motivated and a strong team player,

with a high level of commitment and integrity.

WORK EXPERIENCE

Network Management/ Logistics

United Health Group - Elkridge, MD - November 2012 to Present

Assist in management of a regionally based team of nurse practitioners (roughly 1200) that complete in-

home (HouseCalls) health assessments across the country. Responsible for determining logical approaches to

maximizing personal, departmental, and company based assessment completion targets in Southern Florida.

(720K+ visits completed nationwide in 2013.)

• Represent UnitedHealthcare and the Housecalls Program in a professional and polished manner

• Manage a team of as many as 79 Nurse Practitioners (NPs)

• Review and analyze reports/ data to determine where NPs time is needed (Planning & Scheduling)

• Reinforce network policies, procedures, and expectations

• Track deficiencies in available hourly commitment of each NP

• Logically determine how to maximize time of NP in an effort to secure company productivity goals

• Monitor inconsistencies, visit cancellations, sick time away from work, and paid time off

• Investigate member complaints/ grievances

• Order supplies for NPs as necessary

• Notate incidents/ issues

Provider Relations Coordinator

Advantica, LLC - Ellicott City, MD - November 2011 to Present

Highlights

Collaborate and follow- up internally with operations teams to ensure completion of provider issues

• Provide timely and knowledgeable response to business inquiries

• Selected as Co-contributor to company’s quarterly newsletter “task force”

• Research billing/claims errors and related issues

• Use professional office skills; phone manner, data entry, oral communication, maintenance of files and

records, and composition of routine correspondence.

Credentialing Coordinator

Advantica, LLC - Ellicott City, MD - July 2009 to November 2011

Highlights

• Improved personal records processing time through implementation of efficient filing and data analyzing

process (from 30 to 50 files weekly)

Implemented records system for internal and external auditing purposes

• Assisted in department preparation for annual audits

• Utilized medical information databases (NPDB, EPLS, NPPES, etc.) to research Medicare fraud,• Submitted researched and edited reports to Credentialing Committee of executive level staff

• Communicate effectively with National State Boards of Optometry to verify medical credentials, licensing, etc.

Customer Service Representative

Advantica, LLC - Ellicott City, MD - July 2007 to July 2009

Highlights

• Maintained goal requirements in a high call volume, inbound customer service setting.

Assisted in investigation of claims issues/ errors.

• Verify benefit coverage and schedule appointments

• Use professional office skills; phone manner, data entry, oral communication, maintenance of files and

records, and composition of routine correspondence

EDUCATION

B.S. in Sociology (3.1 GPA)

Towson University

January 2007 to January 2009

Anne Arundel Community College

2004 to 2006

SKILLS

•Administrative Support•Troubleshooting and Problem Solving

ADDITIONAL INFORMATION

Office Skills:

• Office Management

• Group Facilitation

• Leadership Skills

• Strong Written/ Oral Communication skills

• Time Management

• Research & Quality Assurance

• Exemplary Customer Satisfaction skills

• Interviewing

• Records Management

Computer Skills: • MS Word • MS Excel • MS PowerPoint • MS Outlook • MS Access • Windows

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