Amber Gross Email & Phone Number

-Review escalated audit disagrees to determine final outcome-Develop and execute training initiatives for team and help maintain inter-plan guideline documents-Assist in the execution, trending, education and reporting of quality audit samples

Chattanooga, Tn

• Adhere to corporate changes, divisional guidelines and government regulations • Provider clear and concise communication on company and policy change through email and inbound phone calls • Provide a level of service to brokers and group administrators that maximizes satisfaction with BCBST to ensure commitment of our existing business and to foster growth of new business • Maintain acceptable MTM quality accuracy based on division guidelines• Communicate benefit and claim processing details to brokers and group administrators• Assist with technical support to brokers and group administrators accessing the BlueAccess website to process payments and make plan changes.

Chattanooga, Tennessee Area

• Trained PIO new hire classes on how to utilize Ulysses once on the phones and handle calls correctly based on department guidelines and adherence standards• Coached PIO new hire class during first month in class by having them shadow with me and go over call expectations• Maintained gold or platinum level adherence and performance scores• Utilize BlueAlerts, Facets Online Help, BCBST.com, BluesFlash and Web at Work to stay updated on commercial policy and procedure changes• Over 2 years of Facets experience• Effectively educate providers on billing standards, policy details and claim processing information

-Identify errors by utilizing company policies and procedures-Proactively research error trends to identify when procedure/resources need to be developed or changed-Assess quality issues and determine resolutions based on individual and team evaluations-Perform audits for correspondence, web inquiries and customer service representatives- Suggest improvements to Online Help verbiage for consistency on handling correspondence/phone calls

-Evaluated claims for recommendations for resolution using policy guidelines and corporate instructions.-Authorized payments and recoupments-Determined final resolution on reconsideration requests and forwarded appeals to the appropriate department for review-Processed correspondence-Handled customer service calls when requested

• Facilitated new hire training classes for customer service representatives • Managed time, adherence and performance requirements for all trainees• Responsible for performance reporting such as testing, coaching, error resolution and quality standards for graduation• Identified and updated training resources to ensure material covered is relevant

Chattanooga, Tennessee Area

• Designed presentations to realtors during special project assignment to educate them on the basics of property and casualty insurance and how it can benefit their clients• Presented weekly training material to realtors to follow-up on presentation content• Developed follow-up program that allowed realtors to create a checklist to go over with clients when presenting insurance information we discussed in presentation• Consulted clients on insurance package benefits and coverage• Obtain and examine all relevant information in order to assess possible claims• Contact Clients in order to respond to coverage questions or notify them of policy changes

Chattanooga, Tennessee Area

• Formatted and revised company policy and procedure manuals • Assisted human resources department with policy and training updates• Organized confidential documents and maintained company filing system• Managed employee uniform program

Chattanooga, Tennessee Area

• Gathered detailed accident information from policyholders for claims adjusters. • Maintained confidential client database. • Formed professional relationships with clients to ensure retention.• Provided assistance to Agent in claims and client policy updates.• Met weekly with policy holders for insurance review • Completed State Farm’s Auto/Fire policy training program in Murfressboro, TN