Quality Assurance Specialist & Medicare Plan Specialist
Orlando, Florida Area
• Experienced in listening members and customer service recorded phone calls to ensure compliance with client metrics, state, federal and legal regulations.• Audited chats for proper compliance in sales, customer retention, federal employees and commercial business lines (Wells Fargo, Amazon, California Public Employees’ Retirement System - CalPERS and Nike).• Monitored compliance with state insurance department, HIPAA, PHI, PII and ethical and legal regulations.• Partnered with the senior management leadership team and quality leadership to provide feedback and recommendations that improved service level and the quality of the calls.• Collaborated in the designing of the major client Kaiser Permanente QA-based guidelines, scripts and training material based on trends. • Analyzed life and health licensed agents’ performance metrics, compared trends, provided feedback to team leads to improve agents’ performance, and recommended coaching as needed.• Developed an internal chat for licensed agents that enhanced productivity from 40% to 90%.• Worked with multiple systems: Customer Relation Management (CRM), and client-based applications. • Conducted in calibration sessions and trainings.• Took incoming calls to discuss Kaiser Permanente Senior Advantage Health Insurance plans.• Completed telephonic enrollments.