Customer Service Quality Control
Resume:
DEIDRE DAWSON
PROFESSIONAL EXPERIENCE
Quality Control Auditor
HealthSmartRX/HelpScript, Richardson, TX 4/2023 – 5/2025
Audit a variety of transactions and internal processes including claims, training, outreach applications, account setups, and enrollments
Evaluate documentation of policies and procedures for operational compliance
Assess plan documents and regulatory adherence
Conduct data audits across transaction types
Review inbound/outbound telephone interactions for quality assurance
Verify system setup and output accuracy, including calls, claims, and reports
Execute additional tasks and special projects as assigned
Patient Advocate
HealthSmart RX, Richardson, TX 10/2022 – 4/2023
Handled telephone inquiries with professionalism, ensuring accuracy and empathy
Resolved issues on the first call by identifying caller needs, including eligibility, benefits, claims, billing, and provider assignments
Logged all interactions clearly and completely
Performed follow-up to close out open inquiries efficiently
Partnered with internal and external stakeholders to resolve complex issues
Intervened with care providers on behalf of patients
Maintained strong knowledge of claims processes and regulatory guidelines
PCC Agent – Pulmonary Team
Alliance RX Walgreens Prime, Frisco, TX 7/2020 – 10/2022
Scheduled multiple specialty medication deliveries daily for patients nationwide
Collaborated with insurance and financial assistance teams to secure funding or grants
Maintained a patient-first approach with professionalism and confidentiality
Participated in special project inputting data for over 2,800 acquired Kroger Pharmacy patients
Total Loss Specialist/Senior Coordinator
Capital One, Plano, TX 3/2016 – 6/2020
Coordinated with insurance companies, DMVs, and dealerships to handle total loss claims
Processed gap insurance, warranty refunds, and final loan payments
Managed sensitive customer data and guided them through vehicle transition processes
Ensured accurate title delivery post-loan closure
Contributed to various special projects
EDUCATION
BA Communications
Azusa Pacific University
1992
SKILLS
Teamwork
Critical thinking
Time management
Leadership
Adaptability
Proficient in Microsoft Office
Team Collaboration
Cross-functional communication
HIPPA Compliance
Medical Terminology
VOLUNTEER EXPERIENCE
Make-A-Wish Foundation
Wish Granter
Utah, 2001-2007
Make-A-Wish Foundation
Wish Ambassador
Utah, 2001-2007
**********@*****.***
Prosper, TX, USA
SUMMARY
Dedicated and results-driven professional with over 8 years of experience in healthcare operations, quality control auditing, patient advocacy, and customer service. Proven track record of exceeding performance goals, ensuring compliance with regulatory standards, and enhancing patient and customer experiences. Strong analytical skills with a keen eye for detail in auditing claims, calls, documentation, and system outputs. Adept at resolving complex issues, collaborating with cross-functional teams, and driving process improvements. Recognized for professionalism, adaptability, and commitment to excellence in high-volume, fast-paced environments.
CONTACT
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