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.

-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