Call Center Quality Assurance

Danielle E Smith

Contact Phone: 281-***-****

Email Address: adzih0@r.postjobfree.com

Professional Summary

A resourceful call center supervisor who has extensive experience in achieving successful performance and service levels by working with operations across various departments. Effective problem-solver who is dedicated to streamlining operations to promote organizational efficiency. Highly committed to working hard and providing quality customer services, health care management, and/or products. WORK EXPERIENCE

Kelsey-Seybold Clinic 11511 Shadow Creek Parkway, Pearland TX 77584 Healthcare Workforce Supervisor II Nov 2019- Present Supervises a team of 10 direct reports. Provides coaching tools, development reports, and support to 450+ agents in the contact center. Monitors call center volumes from 7,000-10,000 calls inbound and outbound from 1500-2500 calls daily. Creates production reports for forecast call volume, staff needs, and employee schedules. Uses Calabrio, CUIC, CCE, and Cisco-supported programs to identify trends in volume, create schedules that will address needs of (service level) SL%, and educate leadership on developments. Creates KPIs, job descriptions, interviews and hires new employees. Coordinates special events to celebrate agents or holidays. Re-structures WFM utilizing Calabrio, improving, and sustaining service level. Improved team performance and managed special projects for the organization, Oracle Command Center. Creates protocols in the contact center for leadership and trained new supervisors. Updates shift changes in the Calabrio /Verint Workforce system. Responsible for managing and resolving call escalations and enforcement of Corporate and Call Center policies. Received the 2022 Mavis P Kelsey Award and the 2023 Optum Superhero Award for excellence.

Acclara Solutions LLC, 10713 West Sam Houston Parkway North, Ste 600, Houston TX 77040 Revenue Cycle Supervisor July 2017- September 2019 Supervised a team of 20 insurance follow-up agents. Conducted interviews, onboarding, creating schedules

(breaks/lunch), maintaining service levels, and training new hires. Initiated monthly collector performance and Quality Assurance reviews. Monitored development, initiated training of new protocols, coaching for existing team members, and resolved care call escalations. Responsible for workforce management, client presentations for inbound and outbound call volumes, and provider or patient escalations. Coached agents to performance metrics ACW, Adherence, production, and quality assurance. Managed outbound campaigns of 500-1900 accounts, reviewed team production calls per day, Corrected claims, and posted payments regarding ICD 10 CPT coding/ ICD9 Codes, abstracting, and healthcare billing and collections. Rebilled 1500 and UB04 based on provider denials. Created A/R project review reports. Utilized Epic system to audit account maintenance, unpaid claims, self-pay accounts, and insurance denial and appeals. Danielle E Smith

Contact Phone: 281-***-****

Email Address: adzih0@r.postjobfree.com

2

Patient Matters LLC, 3003 S Loop W, Houston TX 77054 Insurance Team Leader November 2014-June 2017

Worked as a leader in the inbound and outbound call center Customer Service Department. Responsible for a team of 30 + employees, which included hiring, terminating, and disciplining employees, scheduling employees, setting work priorities, conducting staff meetings, counseling, and training employees, and evaluating performance.

Orchestrated Revenue cycle healthcare projects within strict timeframes and budget constraints by solving complex problems and working closely with senior leaders Responsible for workforce management and handled call escalations. Created Quality Assurance standards and supervised the quality assurance team for the department calls. Handled client conference calls and onsite training for out-of-state clients. Getix Health, 14141 Southwest Freeway, Ste. 300 Sugarland, TX 77478 Senior Support Analyst January 2012 – November 2014 Led a team of 10 collection specialists. Resolved patient and insurance claim disputes regarding billing or care at Dignity Health for the southern region. Audited medical records, created reports, and forwarded the escalations to the appropriate department for final review. Reviewed and collected on medical claims for overpayments using various techniques and systems HEDIS results using organized charts or Electronic Medical Record (EMR) systems including NASCO and/or WGS systems-based queries, specialized reporting, DMEs, and claim research. Composed letters and verbal notifications with patients. Created reports to identify trends and create training protocols. SKILLS AND SOFTWARE

Proficient in Excel/Microsoft Word/ Sales Force/Skype/TEAMS/Budgeting/ Forecasting Business Development/ Strategic Planning/Business administration/Financial Management Interpersonal Communication/Adaptability/Complaint resolution/Planning and Coordination Proficient in CUBS, SMS, HSRM, Siemens, Artiva, Workstation, SMS Invision, IDX, Meditech, MS4, Cisco Unified Intelligence, Cisco, HBOC Star, CARS, Instamed, Periscope, SoftAgent, Calabrio, Verint, Avant, UKG, Kronos Epic. CPT codes 9/10 UB04, HICFA claim forms, and medical notes. EDUCATION

Franklin D Roosevelt, Hyde Park, NY 05/2002

High School Diploma

References Upon request, references can be provided

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