Service Escalations Account Manager

LINDSAY GREEN

Cypress, TX

614-***-**** ******.*****@*****.***

PROFESSIONAL SUMMARY

•Passionate and committed RSS advocate and trainer with a strong background in OJT and Team Lead roles

•Deep expertise in Medicare & Retirement (M&R) plans across multiple lines of business

•Skilled in underwriting, risk management, leave management, and customer service excellence

PROFESSIONAL EXPERIENCE:

UnitedHealthcare

Service Escalations Account Manager July 2025- Present

Serve as the primary point of contact for escalated service issues from clients, members, or internal teams.

Investigate and resolve complex service problems related to benefits, claims, eligibility, and provider issues.

Collaborate with cross-functional teams (e.g., claims, clinical, IT, provider services) to drive resolution.

Track and document all escalations, ensuring timely follow-up and communication with stakeholders.

Identify trends in escalations and recommend process improvements to reduce future issues.

Provide detailed reporting and updates to leadership on escalation trends and resolution outcomes.

UnitedHealthcare

Operational Trainer / T2 Resolution Support Specialist July 2023 –June 2025

•Facilitated multiple uptrains and workshops for tenured advocates

•Stepped in to lead new hire training classes as needed

•Supported Tier 1 benefit advocates during member calls, maintaining 100% quality

•Sent requested documents to members on behalf of benefit advocates

UnitedHealthcare

On-the-Job Trainer Nov 2021 – Jul 2023

•Trained new advocates on tools and resources for success

•Coached advocates by reviewing calls and providing feedback

•Provided real-time support via Microsoft Teams during live calls

•Sent daily adherence reports and managed schedule exceptions

•Reviewed UES survey scores with advocates

UnitedHealthcare

Customer Service Benefit Advocate Sep 2020 – Jul 2023

•Resolved member inquiries related to benefits, eligibility, claims, and more

•Educated members on consumer-driven healthcare and plan options

•Scheduled appointments and coordinated with internal specialists

•Tools: Maestro, COSMOS, Knowledge Central, Qualtrics, Qfiniti, Nexidia, ICUE, MARX, Rally, Solutran, NICE, Hawkeye Scheduler

York/Sedgwick

Disability Claims Specialist Apr 2019 – Mar 2020

•Processed and reviewed FMLA eligibility and claims

•Ensured compliance with federal and state FMLA guidelines

•Managed a caseload of 250–300 claimants

•Maintained quality scores above departmental expectations

Nationwide Insurance

Associate Underwriter Oct 2015 – Oct 2018

•Monitored policy compliance with state and company guidelines

•Led new hire training on homecare inspections (Sep 2017)

•Achieved 56.1% Loss Record Review actionability (vs. 41.7% avg.)

•Maintained 98.11% quality score (goal: 94%)

•Led root cause analysis projects and mentored new hires

Member Care Representative II Feb 2014 – Oct 2015

•Handled inbound calls and policy inquiries

•Served as Subject Matter Expert for peers

•Processed policy changes and resolved billing issues

•Achieved 97.33% year-end quality score (goal: 98.5%)

EDUCATION:

University of Arizona – Forbes School of Business and Technology

•B.S. in Human Resource Management (Anticipated Graduation: 2026)

CERTIFICATIONS:

Medicare and Retirement Certification, Level 1 – UnitedHealthcare (2020)

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