Customer Service Quality Assurance

Diane A. Sturkey

**** ******** *****

Calumet City, Illinois 60409

Home: 708-***-**** Cell: 708-***-****

*********@*******.***

Objective

As demonstrated in my resume I have extensive experience in management, customer service and medical billing. I

am seeking a

position where I can excel in a customer service or medical billing and coding environment. I have the ability to

execute a variety of

projects simultaneously and deliver excellent results.

Professional History

SPi Healthcare – Tinley Park, Illinois 10/2009-01/2014

Quality Assurance Manager

• Developed, designed, and implemented the Quality Assurance (QA) call monitoring program

• Created forms and metrics to measure performance and customer satisfaction

• Developed effective monitoring tools and technologies to collect and analyze agents performance

• Responsible for ensuring high quality customer service and positive customer experiences.

• Supervised 6 Quality Assurance specialists, 4 - offshore, 1 in Tinley Park, 1 in Greensboro, NC.

• Monitored inbound and outbound calls to patients, doctor’s offices, and payers

• Conducted and documented 10 to 20 audits monthly for each call center agent, 25 – 38 agents across 2

call centers

• Conducted and documented 5 to 10 audits monthly for each Third Party Follow Up team member for a

high volume client

• Deliver written monthly audit reports to call center agents and management

• Provide monthly written feedback and documentation of performance issues to agents/management

• Provide constructive coaching, feedback related to quality, procedures and clients guidelines.

• Conducted weekly call calibration sessions for management & QA specialists, to regulate standards and

maintain consistency of call handling and continuity of clients’ policies and procedures

• Recommend and provide additional training to call center agents as it relates to QA findings

• Responsible for implementation of Quality Assurance call monitoring program for offshore call center

• Responsible for QA training for offshore QA specialists

• Conducted call calibration sessions with offshore call center management and QA specialists

• Documented quality issues, trends, recommend procedure or process changes

• Facilitate client(s) and system(s) training for new hires

• Monitor new hire calls during their first 90 days

• Ensure additional training for new hires as needed

• Responsible for maintaining training manuals and sending client(s) updates and policy/procedures

changes to staff

• Work with Project Manager(s) to assist with implementation of new clients

• Developed written policies and procedures for new clients

• Assist with training of new clients’ policies and procedures to call center agents

• Review escalated issues and provide written documentation of incident to call center and executive

management

• Inform Customer Service Manager of overall quality assessments and training opportunities

• Utilized 12 different systems on a daily basis to assist callers and ensure customer satisfaction.

• Reviewed ICD-9 CM & CPT codes for physician billing issues

• Strong knowledge of three different IDX systems (web and DOS based), EPIC, Avaya phone system,

phone reporting and Cerner system.

Customer Service Manager 03/2008 – 10/2009

• Managed a staff of 25 customer service agents for one particular high volume client

• Maintained attendance and personal records for 25 customer service agents

• Addressed performance issues with agents

• Prepared/delivered monthly productivity reports to agents in one on one sessions

• Held monthly team meetings to discuss performance issues, customer complaints, client issues

• Prepared monthly team accomplishment reports for Director

• Prepared/delivered yearly performance reviews for customer service agents

• Handled high volume of escalated calls from customers and provided issue resolution

• Maintained constant communication with hospital personnel business office and doctors’ offices

• Reviewed accounts to ensure proper handling

• Maintained daily communication with client contact to resolve patient issues

• Monitored daily client ASA(average speed answer) and call volume

• Monitored agents calls to ensure consistency and compliance of client’s policies and procedures

• Implemented policies and procedures to improve workflow and handling of accounts

• Ensured proper training of new hires

• Ensured continuous training of staff

Automated Health Systems – Schaumburg, Illinois

11/2006-02 /2008

Customer Service/Enrollee Supervisor

• Conducted new hire training

• Support for the Call Center-customer service reps – took Supervisor calls as needed

• Support for Outreach Enrolled field personnel – answered their recipient/health center enrollment

questions

• Supervised 6 data entry agents

• Supervised 18 customer service reps performance

• Addressed attendance and performance issues for 24 reps

• Monitored and evaluated 24 reps performance

• Prepared performance reviews for 21 reps

• Managed special projects – Oversaw Enrollments/PCP Recipient link problems

• Prepared and maintained enrollment status reports for the State of Illinois Medicaid recipients to a

primary care provider

• Liaison between State of Illinois-Health & Family Service and Enrollee Services Department

Warner Candy – Elk Grove Village, Illinois

03/2005-10/2006

Accounts Receivable Clerk

• Posted daily 200 - 300 payments for distributors/ customer accounts

• Made collection calls on past due accounts as needed

• Reconciled product problems - damaged, missing or incomplete orders

• Maintained accurate records to verify payment deductions taken

• Tracked returned orders and credited accounts accordingly

• Handled special projects as assigned

Customer Service 05/2004-

03/2005

• Heavy Data entry – entered 300-500 product codes for specialty stores and distributors’ orders

• Received high volume inbound and made outbound customer service related calls

• Prepared reports of warehouse and distributors orders placed weekly

• Filed warehouse and distributors invoices weekly

• Tracked shipping and delivery of distributors’ orders

SMG- Scott Peterson – Hillside, Illinois 03/2003-

04/2004

Deduction Analyst

• Sent out deduction-shortage memos to brokers to notify them of customer deduction request

• Researched accounting/payment history for duplicate deductions

• Applied existing credits to open deductions

• Researched product price sheets and deal allowance reports for accuracy of off-invoice deductions

• Checked weights and prices per pound for accuracy prior to clearing deduction

• Contacted sales person for authorization to clear deductions

• Maintained follow up for authorization and repayment from customers

• Maintained file by customer of special allowance given thru marketing programs or margin set up by

the sales staff

Administrative Assistant 09/2000

-03/2003

• Performed administrative and secretarial duties for Sales Managers/Sales Representatives

• Heavy data entry 150- 200 Clients’ orders daily

• Managed all private label vendor accounts

• Ordered and maintained kitchen, office supplies and equipment

• Distributed daily mail and mail out distributors’ weekly statements

• Responsible for preparing and updating product prices/weekly price sheets

Elrick & Lavidge –Westchester, Illinois 06/1998-

07/2000

TRC Manager

• Managed a staff of 86 employees and 7 supervisors within an outbound market research call center

• Worked directly with TRC Managers, Project Managers and Account Executives to ensure product

information transfer to call center interviewers and supervisors

• Developed and implemented training programs

• Completed performance assessments, provided constructive feedback and conflict/issue resolution

• Designed spreadsheets detailing phone center projects and hours needed to complete each project

• Prepared monthly status/attrition reports

• Scheduled staff working hours and employee holidays

Supervisor/part-time 09/1992-06/1998

• Supervised 85 interviewers on the night shift

• Supervised/monitored market research projects

• Prepared daily status reports for each open research project

• Monitored interviewers’ calls to ensure clients recruiting guidelines were consistent across

interviewers

• Prepared and delivered monitoring reports to interviewers, management and Project Managers

• Prepared evaluations for raises

GMPP/MIC Insurance(Division of General Motors) –Itasca, Illinois

04/1972-06/1999

Processing Specialist, Claim Payor, Claim Clerk, Salvage Clerk, Cancellation Clerk

• Processed mechanical insurance agreements

• Handled inbound calls to call center

• Provided resolutions for claim inquiries while providing superior customer service

• Handled Dealer/Customer claim inquiries via phone, email and written correspondence

• Data entry in various software applications

• Processed claims and requisitioned payments to dealers/customers

• Reviewed and authorized claim payments to dealers

• Reviewed and identified claim coding errors

• Prepared daily report of manual claim volume received and batched new claim invoices

• Prepared and updated IRS tax forms

• Maintained mechanical labor/parts bulletins for Claims department

• Prepared vehicle salvage titles and forms

• Handled cancellation request/refunds for customers/dealers

EDUCATION

Loop Junior College, Chicago, IL 1968-1969 – Math major

Triton College - 2 years general college courses 1969 - 1970

Triton College - General Motors Auto Technology Program and Continuing Education courses – 1976,

1978

Triton College – Computer Certifications – Microsoft Word, Excel,

Certificates obtained in Introduction to Medical Billing and Medical Insurance Terminology and Medical

Terminology

Certified Professional Coder – Certified CPC-A, Magna Cum Laude, July 2014

SKILLS

Proficient in Microsoft Office Suite, Word, Excel, PowerPoint, Access, Visio

IDX, EPIC, Meditech, Avaya Phone System, Call Copy/Quality Assurance Program System, Stockamp

Invoice Tracking System

CPC-A (Certified Professional Coder-Apprentice)

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