Provider Installation | WellMed | 09/2019 – Present • Maintain and update provider demographic, billing, and network contract information within IKA.
- Ensure adherence to quality measures, regulatory compliance, and reporting standards.
- Identify opportunities for process improvements and recommend optimization strategies.
Senior Customer Service Quality Audit
Representative | UnitedHealthcare | 03/2008 – 06/2019 • Monitored and assessed customer service interactions, analyzed performance data, and provided actionable feedback to improve processes.
- Conducted call audits by reviewing recorded interactions to ensure compliance with quality standards.
- Identified trends and patterns requiring process or agent-level improvements to enhance customer satisfaction.
- Delivered constructive feedback and training to agents, refining communication techniques and service delivery.
- Analyzed key performance metrics (e.g., call duration, resolution time, customer satisfaction scores) to identify areas for improvement.
- Ensured compliance with company policies, industry regulations, and quality standards.
- Led QA calibration meetings, ensuring scoring consistency and alignment with performance goals.
Correspondence
Representative | UnitedHealthcare | 05/2004 – 03/2008 • Managed incoming provider and member correspondence, ensuring timely and accurate responses.
- Drafted professional correspondence to address claims, billing, payment issues, provider changes, and prescription concerns.
- Researched and processed provider requests for member reassignment due to non-compliance issues.
- Provided in-person customer support to resolve complex member concerns at local office locations.
