Customer Service Quality Assurance
Resume:
DONALD JONES
Address: ***** **** *** ****, ** *3549 Phone: 813-***-**** Email:***********@*****.***
QUALIFICATIONS
Extremely motivated Customer Service and Member Enrollment Manager with six years of office management experience with a high degree of efficiency. Served as primary point person for all managers, sales team, client relations, and vendors to ensure customer and vendor satisfaction. Established communication skills, problem resolution abilities with a high level of confidentiality.
WORK EXPERIENCE
Quality Health Plans
Manager of Customer Service and Member Enrollment March 2011 – May 2012
• Collaborates with administration to disseminate essential information throughout the organization in weekly companywide education sessions.
• Performs quality assurance reviews of completed calls to ensure compliance with HIPPA guidelines are met as well as complete customer satisfaction.
• Uses quality assurance audits to establish trending topics to incorporate into Customer Service guidances.
• Responsible for the analysis of daily call volume reports, trends, and forecasting.
• Processes data files for enrollment, PDE, RAPS, and SNP submissions to CMS.
• Ensures timely processing of all enrollments received to meet all CMS guidelines and regulations.
• Communicates with plan vendors to guarantee accurate vendor eligibility files are received from the plan.
• Coordinates the completion of approved administrative projects to meet target timeframes.
• Identifies individual areas of improvement in daily processes that are critical to exceed customer expectations.
• Responsible for interviewing, hiring, peer mediations, and terminations for the Customer Service Department.
• Continuously examines departmental policies and procedures for content, efficiencies, effectiveness, and implementation.
• Researches and employs innovative technologies available to assist Customer Service Representatives to better serve our customers.
• Reviews and executes all directives received by administration or compliance officers.
• Serve as subject matter expert for the Customer Service Department.
Copytalk (Athens, Gainesville, Sarasota)
Member of the Board of Directors August 2009 – March 2011
Senior Call Center Manager March 2005 – March 2011
• Directed staffs of up to six managers with 300 direct reports.
• Five years project management experience, including establishing new call centers as well as consolidating existing sites for the financial and insurance industries.
• Maintain proficiency of all existing applications required for the success of this position and on any new platforms that may be developed and implemented throughout all locations.
• Provide executive-level administrative support to the CEO of Copytalk.
• Coordinated projects and events exercising ability to manage, improve procedures, and meet demanding deadlines.
• Liaison between all departments to ensure proper communications and reporting practices.
• Manage capital purchases, direct vendor relations, generate and maintain equipment tracking records.
• Process monthly expense reports reflecting supporting documents and budget indexes.
• Prepare and maintain weekly attendance and annual vacation records on 300 departmental employees.
• Collaborate with departmental managers on weekly postings for master reports.
• Facilitate the accurate and timely writing, editing, and preparation of documents for distribution.
• Assist the CEO with troubleshooting of hardware and software.
• Ensure compliance with all customer service level agreements.
• Provide monthly analyses of performance trends and recommended solutions for any areas having downward trends.
• Ensure stringent adherence to company policies and procedural guidelines.
• Provide timely and effective resolution of a broad range of customer inquiries.
• Strive for one call resolution of customer issues.
• Provide feedback of quality assurance audits to help develop strong Customer Service Representatives.
• Recommend resolutions for CSRs to be able to maintain high quality with an efficient turn around.
• Define and implement effective corrective actions and monitor post-implementation effectiveness.
• Collected operational data and prepared productivity, quality, and volume metrics.
SKILLS
• Proficient with Microsoft Office utilities (Microsoft Word, Power Point, Excel, Visio, and Access)
• Ability to instill the company’s vision and develop an atmosphere of teamwork focused on meeting organizational and corporate objectives.
EDUCATION
• Santa Fe Community College, Gainesville, Fl – A.S. Business Administration
REFERENCES
Francoise Culley-Trotman
Compliance Officer for Quality Health Plans
********@********************.***
Jill Demain
Compliance Officer for Quality Health Plans
*******@********************.***
Alissa Judge
Project Manager for Quality Health Plans
******@********************.***
Farrah Sanabria
Human Resources for Quality Health Plans
*********@********************.***
Douglas Shields
CEO of Copytalk
*******.*******@********.***
Kent Florian
Director of IT for Copytalk
****.*******@********.***
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