Team Lead Quality Assurance
Resume:
Crystal Pastrano
Quality Assurance Grievance and Appeals Auditor Team Lead
San Antonio, TX 78239
*******************@*****.***
I am currently a Team Lead for Quality Assurance Grievance and Appeals Auditors. My job consists of overlooking a team of auditors and ensuring all complaints, grievances and appeals for claims or PreAuthorizations are correct and completed in a timely manner. I work with excel sheets, Microsoft word, Microsoft 365 and I also create trackers to follow any trends or discrepancies that may occur during an audit.
Interpreter Services Coordinator who is dedicated in providing face to face Interpreters for members who are in need of language assistance at dental appointments. Team Lead/Customer Service Representative who is dedicated in providing a high level of great customer service.
Friendly and reliable associate who learns new concepts and skills in assisting customers with their call experience. As well as showing skills in a challenging and fast paced environment. Authorized to work in the US for any employer
Work Experience
QA Grievance and Appeals Team Lead
UnitedHealth Group-San Antonio, TX
March 2023 to Present
Maintaining an Audit Team and ensuring the Audit process is completed in a timely manner. As well as creating trackers for accuracy and errors. Documentation for things that may apply to the audit process. I also conduct 1 on 1 and coachings with the team to ensure everyone is in track. Interpreter Services Coordinator
MCNA Dental-San Antonio, TX
November 2022 to Present
As an Interpreter Service Coordinator my job is to ensure all incoming requests are processed in a timely matter to ensure and Interpreter will be available for our member's upcoming Dental appointments. I also confirm appointments with facilities and provide them with the assigned Interpreter's name. As well as follow up with appointments to make sure Interpreters were present for the assigned appointment. Member Service Representative (MSR)
MCNA Dental-San Antonio, TX
January 2021 to Present
I am a Tier 1 Member Service Representative who assists members in a professional and respectable tone. My job includes assisting members who are trying to find dental facilities and providers in their area as well as dental specialists and assigning them to new facilities. I also assist facilities calling to verify patient accounts and eligibility, faxing eligibility forms to facilities per request as well as assigning new patients to the facilities, and issuing new dental ID cards out and notating all accounts properly into the system.
Stockroom Associate
Ross Dress For Less-San Antonio, TX
June 2019 to Present
Unloading truck and working hardline, processing merchandise and running them out to the shelves. Also training new hires
Team Lead
MCNA Dental-San Antonio, TX
June 2021 to November 2022
Former Team Lead was training for a Supervisor position. I was only been with the company for a little over a year and have moved up 2 positions. I ensure all my agents are in queue assisting with calls for members calling about their dental benefits, claims, grievances, and appeals. I also take escalated calls and I do data entry such as attendance, stats, lunch times as well as entering data in trackers. I have 6 weeks experience as Quality Assurance Analyst. I monitor calls and ensure that the agents in my team are following policies and procedures as well as grading and coaching the calls and agents. I also have training experience as well as payroll experience and confirming payroll. I hope to become an operations manager or call center manager in the near future
Tier 1 Technical Support
Ibex Global-San Antonio, TX
August 2020 to September 2020
Tier 1 tech support for phone company. Helped with troubleshooting problems customer assistance/in charge of store
black fox beauty supply
January 2014 to March 2016
Market Research Analyst
Creative Consumer Research-San Antonio, TX
July 2007 to August 2008
Inbound and outbound calls to various consumers and conduct market research for several companies for new product ideas. I also hosted research studies for several companies as well. Education
working on getting license
milan institute of cosmetology
Skills
• years of customer service skills (10+ years)
• Market Research (2 years)
• Research
• Technical Support
• Help Desk
• Training & Development
• Marketing
• Branding
• Quality Assurance
• Microsoft Outlook
• Communication skills
• Microsoft Excel
• Data Entry (5 years)
Additional Information
I consider myself a team leader and a go getter. I do go above and beyond to strive for great customer assistance and services.
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