James Gaus Email & Phone Number

Boston, Ma, Us

Waltham, Massachusetts, United States

Deliver best in class support to both sales agents and their prospects, with the ultimate goal of a one call resolution. Educate and guide them as they navigate more than 140 Medicare Advantage plans across 13 states. Provide immediate IT support for all agent portal, certification, and marketing fulfillment issues. Verify prospect eligibility, investigate escalated compliance concerns, and resolve action items that will expedite the enrollment process.• Manage a diverse caseload of both assigned outreaches and ongoing investigations into commission payment conflicts, contracting issues, and member benefit disputes• Collaborated with leadership to build a comprehensive QA evaluation model, and maintain contribution to the ongoing development of SOPs and other internal reference materials• Selected to be an onboarding team lead, where I provide new team members with best practices and tailored training that better equips them to navigate the demands of the role

Woburn, Ma

Supported both patients and care partners to ensure that timely, accurate, and thorough care was provided for various IV infusion therapies. Assisted with scheduling patient visits and coordinating the delivery of medication and supplies. Communicated with healthcare facilities and provider offices regarding physician order requirements and insurance authorizations. Performed billing and claims processing, the screening of new patient referrals, IT support, and other various administrative functions.• Investigated complex collection issues, and researched ongoing invoicing trends in order to more efficiently resolve outstanding claims• Developed reporting that helped to provide insight into nurse productivity and patient satisfaction• Maintained nurse personnel records for immunizations, licensing, payroll, and malpractice insurance

Riverview, Fl

Investigated, analyzed, and documented automotive claims with customers over the phone. Interviewed all involved in an accident and interpreted policies to determine both coverage and liability decisions. Educated policyholders on their coverage and provided additional support throughout the claims process. Managed more than 60 active claims while consistently prioritizing new contacts in a fast-paced environment.• Collaborated with law enforcement to complete scene reconstructions in addition to the analysis of police reports, security footage, public records, and media timestamp data• Effectively negotiated with other carriers to determine the degree of shared liability between drivers• Worked with both estimators and repair facilities to validate that damage was consistent with the accident report, and to identify any other anomalies that might be suspect or unrelated

Tampa/St. Petersburg, Florida Area

Evaluated agent performance daily by monitoring calls for sales, service, and support staff. Conducted in-depth developmental and performance improvement coaching sessions. Collaborated with leadership to provide the feedback needed to properly audit the performance of their teams. Handled an active caseload of more than 50 agents while maintaining a robust schedule of developmental coaching, trend reporting, calibration sessions, and team meetings.• Managed numerous project teams across multiple lines of business that helped to improve overall service level, lower average call handle time, and increase the efficiency of online tools and evaluation processes• Chosen to be the lead facilitator for all inside sales calibration sessions across the Tampa, Tulsa, and Atlanta contact centers• Agents under my guidance consistently achieved overall scores that were higher than any other analyst, with a 10% lower attrition rate than the site average

Tampa/St. Petersburg, Florida Area

Provided support for the moment to moment successful operation of frontline teams. Was an immediate point of contact for escalations, and kept agents focused on efficiently processing contacts throughout their day. Displayed flexibility by conducting daily reporting, auditing delivery invoices, and creating team meeting agendas. Gave specialized customer care as needed in uniquely challenging situations, and ultimately drove client satisfaction and retention. • Recognized with the highest annual performance rating of any support specialist for 2014• Contributed to the development of multiple project teams, pilot trials, and SOPs• Led bi-weekly meetings for frontline teams, delivering updates on new processes and sales performance

Tampa/St. Petersburg, Florida Area

Provided customer service taking inbound calls from both businesses and consumers. Documented product orders and equipment service requests, monitored inventory variances, and educated callers on new products and promotions. Assisted with sales training across multiple lines of business, mentored new hires during the onboarding process, and contributed to the analysis of distribution center data.• Presented with a "Be The Best" award four years in a row as recognition for providing best in class service• Earned an SME certification for the Customer1 and AS400 software platforms• Helped to develop employee incentive projects that led to a boost in site sales performance

Associate Of Science - As, Recording Arts Technology/Technician

Graduate