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Customer Service United States

Location:
Orange Park, FL
Salary:
45000
Posted:
March 28, 2024

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DONNA E. WESSON

Orange Park, FL ***** Cell: 910-***-**** E-mail:

ad4m82@r.postjobfree.com United States Navy Veteran PROFESSIONAL PROFILE

x Education and Training specialist with over 20 years of military and Veterans Affairs (VA) Veteran Health Administration (VHA) experience.

x Proficient in Microsoft Office programs, managing SharePoint and Customer relationship management

(CRM) software, such as Salesforce, to manage interactions. x Accomplished and detail-oriented professional who excels independently and with teams to organize, prioritize, and execute the mission objectives of customers, leaders, and agencies. x Quick learner, mission-oriented, reliable, competent, and energetic team player with solid oral and written communication skills.

SUMMARY OF EXPERIENCE

Over 20 years of accomplished Healthcare Management with diverse experience in Health Administration Services, Strategic Planning for medical operations, Policy Development, Program Management, Inventory Control, Budgeting, and Training. Supervisory responsibilities include positions as Senior Health Services Manager, Operations Manager and Personnel Manager, Training Manager, and Advisor. Possess the leadership and knowledge to perform effectively in various types of organizations. Having the ability to perform in high-stress rapidly changing environments, multi-task, analyze and resolve problems. Results- oriented and highly motivated to succeed with a strong work ethic. Customer Service Manager and trainer. PROFESSIONAL EXPERIENCE

CVS/Aetna Health

March 2023 – Present

Customer Care Partner

x Provide Customer Service to National Account Members by focusing on putting members first. x Assist members with connecting to therapist in local areas as well as virtual. x Assist members with locating resources in the community to assist with emergency and daily needs. x Research insurance information for members

x Locate emergency resources to members.

x Transfer distressed members to inbound clinician for In the Moment Service x Assist members with Human Resources questions.

x Advise members of Employee Assistance Program benefits x Detail orientated.

x Assist colleagues with questions and concerns.

x Ability to manage multiple tasks in a transaction / high volume-based environment. x -Strong communication and problem-solving skills x -Empathy towards customers’ needs and concerns

DONNA E. WESSON

Norfolk, VA 23513 Cell: 910-***-**** E-mail: ad4m82@r.postjobfree.com United States Navy Veteran

2

Blue Cross Blue Shield North Carolina (contract)

July 2020 – March 2023

Customer Service Professional/Team Lead

• Manage policies and procedures, overseeing a team of 35 customer service call center customer service representatives.

• Lead and coordinate the response to major incidents, ensuring timely resolution and minimal impact with the customer issues.

• Train and lead entry level County Engagement teammates as needed to help guide them and create a team of highly skilled professionals.

• Communicating with team members about new programs, training, expectations, and bonus incentives.

• Build and implement programs to create better ways for Blue Cross NC to benefit and enhance relations with the local community. Work to understand emerging issues regarding health care.

• Timekeeping entry and corrections for team members

• Backup Team Lead for different departments.

• Weekly coaching with customer service call center

• Monthly meetings with customer service team.

• Provide warm and professional customer service while onboarding new clients and maintain existing clients, inquiry response, insurance eligibility, claim submissions questions concerning billing and insurance policies.

• Assist clients with claims (such as how to read a claim or calling insurance carrier), questions regarding coverage, or what plan may be best for them.

• Process subscribers/members insurance claims while monitoring the status of existing insurance claims

• Manage electronic records and ensure all contracting paperwork is kept current.

• Researched benefit summaries for members

• Ensured members accuracy with eligibility.

• Assisted with enrolling members during open enrollment.

• Assist clients with claims (such as how to read a claim or calling insurance carrier), questions regarding coverage, or what plan may be best for them.

• Customer relationship management (CRM) software, such as Salesforce, to manage interactions.

• Collaborate with cross-functional teams, including IT, operations, and support, to identify the root cause of incidents and implement preventive measures.

Veterans Affairs Health Administration, Fayetteville, NC May 2015 – June 2020

Administrative Officer

x Plans, coordinates, and monitors programs to improve processes and decision-making. x Provides leadership to ensure compliance with regulatory standards. x Develops and interprets new professional policies and procedures, defining their administrative requirements, and/or providing advice to the Associate Chief of Staff for Education (ACOS/E) and Informatics on related issues.

x Independently conducts special studies on manpower, space, equipment utilization and other resource intense items.

x Provides written or oral reports to the appropriate level of management on findings and assures necessary action is taken to correct out-of-line situations. DONNA E. WESSON

Norfolk, VA 23513 Cell: 910-***-**** E-mail: ad4m82@r.postjobfree.com United States Navy Veteran

3

x Provides support to specific HCS programs as well as special studies, surveys, projects, planning, and overall management. This management includes oversight and the securing of the resources and training of staff necessary to meet and support service goals and related medical center objectives. x Interviewed qualified candidates for positions in multiple departments within the Veterans Health Administration, as well as recommend appointment, promotions, or reassignments to those positions. x Develops performance standards for staff in the ACOS/E and Informatics Line and assure reasonable and equitable performance standards and rating techniques developed by subordinate staff. x Directs, coordinates, and oversees work done by supervisory staff within the ACOS/E and Informatics. Service Line.

x Communicated daily with high-ranking military and civilian managers. Examples include DoD projects with Womack Army Medical Center, Department Chairman, and our Medical School Affiliates, and contracting officials.

x Administers quarterly training on independent living services that are available to veterans that are not able to work due to severe disabilities.

x Coaching and Mentoring.

Veterans Affairs Health Administration, Salisbury, NC August 2006 - May 2016

Outpatient Administrative Support Section Chief

x Supervision of six Supervisory Medical Support Assistants, six Lead Medical Support assistants, and Medical Support Assistants within the section. x Provides overall responsibility for leave, incentive awards, building up stronger morale, administrative disciplinary actions, recruitment, and placement. x Responsible for planning, organizing, directing, and evaluating the clerical and technical staff that provide a wide variety of support to the work of the outpatient clinical staff. x Implements policies and procedures relevant to the Health Administration Services and Outpatient Administrative support section.

x Research education programs that are beneficial to the goals and the initiative of support staff that will aid them in gaining valuable tools for increased productivity within the section. x Provides direct assistants to all surrounding Community-Based Outpatient Clinics. (CBOCs). coordinating the cross-leveling of the workload between each clinic to include Salisbury VAMC, Winston Salem, Charlotte, and Hickory CBOC.

x Coordinating, creating, implementing, and assessing with the Primary Aligned Care Team

(PACT) Medical support Assistant program within the W.G. Bill Hefner Salisbury VAMC, Winston Salem, and Hickory Community Based Outpatient Clinics. x Receive and resolve complaints that come directly from the facility director co-workers and employees.

x Coordinates various and intensive trainings throughout the facility pertaining to scheduling within each clinic in the facility and or within the Community Based Outpatient Clinics ensuring that Veterans are scheduled within a seven-to-fourteen-day time frame. x Responsible for the management of consults and monitoring the Electronic Wait List (EWL). x Ensuring the proper coordination of patient appointments through VistA Appointment Management as reflected in the Computerized Patient Records System (CPRS) are timely and accurate and explained to patients and information is recorded such as the desired date from the veteran and or physician for appointments and procedures required for the appointments. DONNA E. WESSON

Norfolk, VA 23513 Cell: 910-***-**** E-mail: ad4m82@r.postjobfree.com United States Navy Veteran

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x Through knowledge of Eligibility procedures which include but are not limited to enrollment and beneficiary travel for VA medical care, priorities for care, Release of Information (ROI) and HIPAA.

x Serves at the local Patient information Collection Management Coordinator (PICMC) monitoring the Patient information process to ensure the national policy, maintaining the process have been incorporated into facility training programs and performance requirements for administrative staff x Ensuring that all administrative data is entered in accordance with existing Veterans Health Administrative policy.

x Track and monitor phone system(voicemails) per clinic, particularly number of calls answered, length of calls, number of dropped calls, and productivity of staff answering calls. x Ability to communicate verbally and in writing with a variety of people from different backgrounds and different levels of understanding. x Assisted veterans with finding and keeping employment. United States Navy

July 1997 – Mar 2006

Yeoman (Executive Assistant)

x Commander, Amphibious Group Three (COMPHIBGRU 3)- Received and logged over 2,000 personnel award recommendations for 36 subordinate commands including 17 amphibious ships. x Reviewed award recommendations, researched, and gathered data to check for accuracy and timely submission of award packages in accordance with the Secretary of the Navy (SECNAV), COMPHIGRU3, and Commander, Naval Surface Force, United States Pacific Fleet

(COMNAVSURPAC) policies and directives governing the awards program. x Upgraded proposed rough drafts of award citations or re-typed citations to a smooth completion for the Admiral’s signature and assembled award packages for mailing. x Naval Station Police Department (NAVSTA Police Dept)/ Security-conducted fingerprinting for military and civilian personnel.

x Prepared military documents, drafts and typed various correspondences classified and unclassified

(i.e. messages, letters, memorandums, Temporary Assigned Duty orders and enlisted evaluations.) x Prepared, typed and routed correspondences and reports. x Served as Office Manager.

x Performed administrative functions for legal proceedings. x Received and directed telephone calls.

SKILLS

Windows 11-Expert knowledge of Excel, Word, Microsoft Office, Acrobat Adobe PowerPoint, Access, Microsoft Outlook, Microsoft Teams, Finesse, Jabber, Incedo software, VPN access, SPoG software, Aetna Strategic Desktop (ASD) software Microsoft Word Typing (75wpm) Data Entry, QuickBooks Pro Accounting Procedures Ten-Key (by touch)

DONNA E. WESSON

Norfolk, VA 23513 Cell: 910-***-**** E-mail: ad4m82@r.postjobfree.com United States Navy Veteran

5

EDUCATION

Walden University 4.0

Fayetteville University 3.78

US Naval Class A Technical School, Meridian, MS

Extensive training in business office practices and procedures. Kelsey Jenney School of Law, San Diego, CA - GPA 3.3 COMMUNITY SERVICE (VOLUNTEER SERVICES)

American Legion - 2006 to Present

Disabled American Veterans - 2012 to Present

Non-Profit Organizations -2006 to Present



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