TANYA LONDON

225-***-****, ad37xn@r.postjobfree.com

SUMMARY OF EXPERIENCE AND QUALIFICATIONS

I am a dynamic, team spirited management professional with more than 20+ years leading staff in a call center environment. I have a proven ability to lead teams in a manner that enables them to achieve or exceed defined organization goals. I have created and delivered effective training materials in diverse work environments, preparing materials that resonate with individuals of various ages, cultural backgrounds and skill levels. I am an effective communicator with superior time management skills who is skilled at resolving escalated operational situations or issues, while reinforcing customer loyalty and satisfaction.

YEARS OF EXPERIENCE RELATIVE TO SCOPE OF WORK

Call Center Experience

30+ years' experience- Assist in employee performance evaluation, promotion, retention and termination activities. Outbound/Inbound call center experience. Escalation calls experience. Medical customer service, claims, and provider call center experience.

Lead Supervisory/Managerial Experience

30+ years- Conducted performance appraisals semi-annually and annually. Assumed the POC (point of contact) position in the absence of operations manager. Held team meetings on a regular basis with direct employees. Communicated all process and client changes to all agents within specific timeliness Assisted my peers in resolving a. gent performance issues by sharing best practices.

Employee & Staff Trainer/Development Experience

25+ years- Develop professional development plans for employees to improve performance efficiency. Hands on Classroom Facilitator- Strong ability to explain program concepts to non-technical audiences. Present information using a variety of techniques, including discussions, role playing, team exercises and visual materials.

Staff Recruitment and Retention

30+ years- Recruitment Process- Assist with staff recruitment. Coach, motivate and retain staff. Conduct face to face, behavioral, and over the phone interviews/pre-employment screening. Identified staffing needs and submitted requisitions to client to properly manage the staffing levels of the organization.

WORK EXPERIENCE

Supervisor Self-Funded (BBS) & OGB COB, Blue Cross Blue Shield of Louisiana, Baton Rouge, La April 2020 – Current

Provide daily support to claim staff on claim managing and filing activities.

Ensure that claim team follows state regulations and standard operating procedures.

Develop best practices to optimize claim processing quality.

Evaluate professional skills of claim staffs and provide appropriate claim assignments to them.

Perform claim negotiation and confirm settlement amount.

Document claims processing documentation updates/changes

Interact with varies departments throughout the company to address claims processing

Assist in hiring and training new candidates in their job responsibilities.

Monitor individual performance and ensure it meets expected quality and performance objectives.

Develop professional development plans for employees to improve performance efficiency.

Assist in employee performance evaluation, promotion, retention and termination activities.

Perform other related duties and special projects as assigned or requested. Work effectively with other departments in the organization on shared issues and to effect positive change.

Actively monitor and effectively analyze and respond to improvement opportunities and trends identified in information provided in claim management reports.

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Supervisor Fully Insured- Refunds and Adjustments Special Claims Operation, Blue Cross Blue Shield of Louisiana, Baton Rouge, La 2015 – Current

Responsible to adjudicate more complex claims, requiring additional research or problem solving.

Responsible for accurate and timely adjudication of claims according to guidelines.

Provide daily support to claim staff on claim managing and filing activities. Leverages

Ensure that claim team follows state regulations and standard operating procedures. Identifies

Analyze assist claim personnel in coverage investigation, liability analysis and settlement negotiation.

Develop best practices to optimize claim processing quality.

Work effectively with other departments in the organization on shared issues and to effect positive change.

Evaluate professional skills of claim staffs and provide appropriate claim assignments to them

Develop professional development plans for employees to improve performance efficiency.

Assist in employee performance evaluation, promotion, retention and termination activities.

Give directions in claim research, evaluation, investigation assigning claims for processing and recovery procedures within assigned authority in accordance with best practices.

Oversee the refunds unit which identifies claim outflow for retro terms and recover from vendor/providers appropriately

Follow-up on any claims identified refund request to ensure full recovery

Oversight of the retro deducts collections, eligibility collection, and reconciliation processes

Other duties as assigned

Supervisor Claims Control, Blue Cross Blue Shield of Louisiana, Baton Rouge, La 2015 – Current

Provide daily support to claim staff on claim managing and filing activities. Leverages

Ensure that claim team follows state regulations and standard operating procedures. Identifies

Analyze assist claim personnel in coverage investigation, liability analysis and settlement negotiation.

Develop best practices to optimize claim processing quality.

Evaluate professional skills of claim staffs and provide appropriate claim assignments to them

Develop professional development plans for employees to improve performance efficiency.

Assist in employee performance evaluation, promotion, retention and termination activities.

Call Center Supervisor, Enroll Louisiana, Baton Rouge, La 2013 –2014 (Contract Assignment)

Outbound/Inbound calls regarding the Affordable Care Act (ACA) policies during Special Enrollment Period (SEP) & Identifying Qualifying Life Events (QLE).

Direct contact with CMS to ensure compliance & updates to process procedural updates.

Contact with insurers to address any member related concerns regarding data collected and policies. ie..confirm binder payments, member Id

Organizing staffing, including shift patterns and the number of staff required to meet demand Identifies

Reviewing the performance of staff, identifying training needs and planning training sessions

Recording statistics, user rates and the performance levels of the center and preparing reports

Coordinating staff recruitment, including writing vacancy

Monitoring random calls to improve quality, minimize errors and track operative performance

Liaising with supervisors, team leaders, operatives and third parties to gather information and resolve issues

Supervisor-Blue Cross Blue Shield La, Korak Staffing, Baton Rouge, La 2013 – 2014 (8 month contract)

Supervisor within Health Care Reform Unit (HCR)

Supervise 20 customer service reps and 1 trainer/quality advisor.

I assist my peers and complete any task as assigned by management.

I also monitor calls to identify and resolve performance, behavior and attendance issues.

I review and monitored daily Time Management Systems (Beeline), corrections to payroll submission & issues.

Conduct weekly 1:1 development sessions

Review statistics on a daily basis and provide constructive feedback.

Ensure that all employees attend necessary training.

Conduct weekly team meetings on with direct reports.

Communicate all process and client changes to all agents within specific timeliness.

Assist my peers in resolving agent performance issues by sharing best practices

Training Manager/Business Analysis, Xerox Company, Baton Rouge, La 2011- 2013

Training Management- Identify and assess training needs of staff by conferring with managers and supervisors or analysis. Effectively monitor, evaluate, and document effective training activities. Produce training materials for in-house courses as appropriate. Amend and revise materials as necessary, in order to adapt to changes that occur. Complete monitoring’s of random calls to improve quality, minimize errors and track operative performance.

Acts as a support by fielding questions and issues from staff related to the business and / or systems.

Recruitment Process- Assist with staff recruitment. Coach, motivate and retain staff.

Conduct or arrange for ongoing technical training and personal development classes for staff members.

Confer with management and conduct surveys to identify training needs based on projected production processes, changes, and other factors.

Identified knowledge gaps and addressed concerns of the client through thought leadership and analyzing data through daily/weekly reports

Hands on Classroom Facilitator- Strong ability to explain program concepts to non-technical audiences. Present information using a variety of techniques, including discussions, role playing, team exercises and visual materials.

Conduct Needs Assessment and Task Analysis-Work with key stakeholders to generate excitement and buy in of training.

New Hire Training- Coordinate, schedule and conduct business and technical training for new hires and current employees. Course Development- Create training plans, document technical course materials including manuals and exercises. Design training programs to help develop and improve job-related skills

Quality Assurance Department Lead – Supervised and developed quality assurance analyst, conducted weekly call calibration session with on site management staff and the client (Department of Children & Family Services (DCFS)

Worked closely with Senior Management during system enhancements and implementations to identify any training/development needs.

Work Force Management (WFM) call center call routing, scheduling for exempt & non-exempt employees

Planned, organized, and facilitated new hire and continued education training of all employees based on client expectations and business needs.

Help Desk Supervisor, CRM Medical, Baton Rouge, La 2010- 2011 (worked 7am-3pm shift) Contract

Provided technical support to over 14 Medical Hospital ER departments.

Data analysis report reviews submit all findings to management.

Scheduling for helpdesk service associates

Communicated all process and client changes to all agents within specific timeliness.

Processed performance and process improvement plans.

Provided weekend on call support.

Answered incoming calls for office

Maintained records and files for clients.

Supervisor Technical Support, AT&T Mobility, Baton Rouge, La 2010- 2011

Technical Support, AT&T Mobility; Baton Rouge, Louisiana.

Ability to multitask between systems

Provided phone and email support for AT&T Wi-Fi customers, venue owners, internal customers, and roaming partners

Provided product information and walked customers through connection process

Performed email validations and Performed password resets

Provided customers with hotspot location and pricing information

Assisted customers in connecting to the AT&T Wi-Fi network

Configured wireless utility and network settings and Configured proxy and LAN settings

Configured network card settings and Enabled and configures TCP/IP settings

Lead Supervisor Work @ Home, Staples Inc, Baton Rouge, La. 2008- 2010

Responsible for managing and training 15+ customer representatives.

Managed the leadership and supervision of Contract Customer Service Accounts.

Managed departmental budgets and expenses within established guidelines to include proper workforce planning, billing, hiring, training and resource requirements in order to meet service level requirements, accuracy and quality goals, and controlling shrinkage.

Developed associates to achieve the department’s performance goals and objectives. This included on the job training, coaching, providing feedback on performance, and timely delivery of performance appraisals.

Developed and mentored Senior Customer Service Representatives to coach and assist with new hire training and development.

Coached, motivated, trained, developed and guided employee performance through a variety of mechanisms such as observations, metrics analysis, and feedback.

Observed calls in assigned Customer Service and Operations function to ensure proper call quality and productivity.

Managed phone and email support teams remotely. Ensured employees adhered to policies and procedures in the workplace and in the work at home environment.

Public relations issues and conducting performance appraisals on a regular basis.

Account management customer retention team management.

Organization unemployment hearing representative.

Lead Supervisor Inbound Customer Service, Convergys, Baton Rouge, La 2000- 2008

Supervised 25-35 outbound/inbound sales and customer service agents.

Set sales goals based on client expectations ensure that all agents performed in compliance with the set goals.

Daily and weekly coaching and feedback provided to all employees based on their sales performance.

Training employees

Facilitation of weekly calibration sessions once per month discussing the call procedures and sales expectations

Analyzed team sales performance to set developmental goals.

Resolved customer complaints.

Assisted with setting sales based incentive strategies to increase the sales performance of all agents.

Assisted with TKS Time Card Corrections of our local Human Resource Department. Made sure that all correction was made for that department as well as performed corrections for the sales team.

Facilitated mandatory trainings to ensure that all client changes are handed down to all agents.

Modify Sales Operations as needed to meet service level agreements under supervision of Sales Operations Manager.

EDUCATION

Continuing Education, University of Phoenix-Criminal Justice/ Early Childhood Development Child Life Specialist

Hospitality Management-Louisiana State University; Baton Rouge, Louisiana

CERTIFICATION/LICENSURE

Any applicable certifications or licensures (PMP, IEEE, Scrum Master, etc.)

ADDITIONAL QUALIFICATIONS

Project Management

Presentation Development

Medical Insurance Claims Processing

Market Expansion Strategies

Process Optimization and Documentation

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