Andrea Thomas

Dynamic healthcare professional with over 20 years of experience in customer service and provider operations. Proven ability to meet production targets, ensure compliance, and drive process improvements while fostering collaborative team environments. Adept at enhancing provider and member experiences, streamlining workflows, and delivering high-quality support in fast-paced environments.

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.

High school graduate