Create and implement processes ensuring data checks met compliance standards, automated validation activities, and enhanced quality.Managed responses to external and internal audits, ensuring workflows supported compliance and updating protocols to accurately capture procedures, improving Plan Administration compliance.Conducted quality tests on new and revised benefit plans, verified proper claim adjudication, and took necessary steps post-testing to resolve issues and enhance… Show more Create and implement processes ensuring data checks met compliance standards, automated validation activities, and enhanced quality.Managed responses to external and internal audits, ensuring workflows supported compliance and updating protocols to accurately capture procedures, improving Plan Administration compliance.Conducted quality tests on new and revised benefit plans, verified proper claim adjudication, and took necessary steps post-testing to resolve issues and enhance system functionality.Prepared and executed test plans for unit, system, automation, and user acceptance testing, ensuring software products met quality standards.Assisted in phased deployment approaches to facilitate adoption across impacted teams, ensuring smooth transitions and minimal disruptions. Show less

• Analyzing/Interpreting communications flagged by various internal and external sources and investigating clients a member complaint while responding appropriately.• Determining when/if compliance violations were committed.• Writing performance correctional document for sales agents, wellness advocates, And customer service representative • Creating internal reports for operations regarding new compliance cases and updating supervisors• Maintaining reports and audit records of… Show more • Analyzing/Interpreting communications flagged by various internal and external sources and investigating clients a member complaint while responding appropriately.• Determining when/if compliance violations were committed.• Writing performance correctional document for sales agents, wellness advocates, And customer service representative • Creating internal reports for operations regarding new compliance cases and updating supervisors• Maintaining reports and audit records of compliance monitoring and documentation Show less

• Monitor and measure the quality adherence of inbound/outbound calls, emails, chats, and any other method of agent and beneficiary interactions with a 98% accuracy rate.• Escalate weekly/monthly reports documenting errors and finding the appropriate agent and manager, making detailed notes of issues, and providing feedback and making recommendations on how to resolve them.Successfully implemented Salesforce CRM for a team of 20 sales representatives, resulting in a 30% increase in… Show more • Monitor and measure the quality adherence of inbound/outbound calls, emails, chats, and any other method of agent and beneficiary interactions with a 98% accuracy rate.• Escalate weekly/monthly reports documenting errors and finding the appropriate agent and manager, making detailed notes of issues, and providing feedback and making recommendations on how to resolve them.Successfully implemented Salesforce CRM for a team of 20 sales representatives, resulting in a 30% increase in sales productivity.• Maintaining knowledge of all application standards, policies, and regulations related to Medicare and Medicaid guidelines through data collection, analysis, and research reports to improve performance and track trends.• Participate in weekly review meetings including the development information of quality performance working in conjunction with training and on boarding leadership to ensure QA requirements for new hires and call handling process for new programs and/or changes to existing programs meeting performance expectations Show less

• Provide administrative support by handling inbound calls and completing data entry functions while maintaining complex databases.• Responsible for serving as the primary liaison between customers and employees, using best judgment in conjunction with corporate standards to resolve conflicts that arose. • Leveraged Microsoft Excel to analyze wide ranges of business insights to inform and filters data-driven strategic decisions. • Diagnosed errors, technical problems, and determine… Show more • Provide administrative support by handling inbound calls and completing data entry functions while maintaining complex databases.• Responsible for serving as the primary liaison between customers and employees, using best judgment in conjunction with corporate standards to resolve conflicts that arose. • Leveraged Microsoft Excel to analyze wide ranges of business insights to inform and filters data-driven strategic decisions. • Diagnosed errors, technical problems, and determine solutions with 98% success rate, while producing detailed service reports in a timely manner. Show less

Maintain client/division office files, build client relationship. Compiles data and prepares reports and meeting minutes. Time keeping, preparing office correspondences, payroll assistance and staff hiring/termination. Schedules activities for clients and employees. Types letters or prepares routine correspondence. Assists with payroll, benefits, invoices, and accounts payable/receivable. Assists with new hire training and paperwork. Maintain mailing, client referral and master lists and/or… Show more Maintain client/division office files, build client relationship. Compiles data and prepares reports and meeting minutes. Time keeping, preparing office correspondences, payroll assistance and staff hiring/termination. Schedules activities for clients and employees. Types letters or prepares routine correspondence. Assists with payroll, benefits, invoices, and accounts payable/receivable. Assists with new hire training and paperwork. Maintain mailing, client referral and master lists and/or donor databases. Administers first aid as needed. Performs other duties as assigned. Show less

• Exhibit organization skills and discretion by handling confidential information with integrity such as client records and legal documents.• Review and evaluate client contact calls and emails for technical accuracy with a 98% log rate.• Streamlined customer service representatives training programs by documenting procedures and implementing grow strategies, impacting 200+ representatives.• Captured key data points and action items via voice, email, and chat accuracy to improve the… Show more • Exhibit organization skills and discretion by handling confidential information with integrity such as client records and legal documents.• Review and evaluate client contact calls and emails for technical accuracy with a 98% log rate.• Streamlined customer service representatives training programs by documenting procedures and implementing grow strategies, impacting 200+ representatives.• Captured key data points and action items via voice, email, and chat accuracy to improve the effective dissemination of information across the organization.• Transferred written information into database to maintain consistent accurate client records by verifying and updating account information in company computer database. Show less

• Acquired marketing and sales experience by advertising promotions, explaining company policies, and closing sales.• Facilitated effective written communication between colleagues, clients, and vendors to enable collaborative decisions making and operations.• Provided phone and email support while maintaining and memorizing the catalog for over 50+ products resulting in knowledgeable and empowered customer support reaching a ticket resolution rate of over 95% daily.