• Actively manage employee performance through the creation and examination of employee productivity metrics and through periodic performance reviews.• Create a proactive work environment through active coaching and positive reinforcement, focusing on the positive aspects of employee performance to drive employee retention and to improve the overall customer experience.• Standardize phone responses that yield greater customer satisfaction, creating documented processes that provide swift and professional resolutions to problems.• Coordinate staffing and schedules to ensure optimal coverage for incoming phone calls, leveraging historical call trends to determine appropriate staffing levels.• Diffuse customer grievances with a 98% success rate, operating as an escalation contact for customers experiencing unresolved concerns.• Analyze Excel reports using advanced lookup and filtering functions to custom tailor coaching solutions for employees who do not meet the established performance metrics.• Continuously increase employee compliance and productive output by up to 15% through the creation and implementation of employee training programs.• Perform new employee onboarding training, bringing new employees into productivity compliance within 3 weeks of hire date.• Instill a customer service culture that drives a high level of both employee and customer SAT. • Proactively identify opportunities to improve customer experience. • Ensure appropriate staffing levels and manage schedules to ensure optimal coverage.• Act as point of escalation. Interface directly with both customers and internal departments to advocate on behalf of customer needs.• Develop comprehensive training plans.• Take on additional responsibilities and projects as needed.

• Deliver solutions by identifying problems, researching answers, and guiding users through corrective steps. • Deliver clear and concise resolutions to technically vague problems, providing superior customer support to callers with little technical background.• Educate clients and explain features and functionality of software applications. • Use outstanding customer service to troubleshoot and resolve issues in a timely manner.• Improve system performance by identifying issues and recommending changes.• Continue product expertise by updating job knowledge, education training, and maintaining personal networks.• Take on additional responsibilities and projects as needed.

• Expert with Enterprise Document Generation software (Adobe Designer, DocuMakerRP). • Supervised six employees, meeting all production deadlines. • Designed effective correspondence, conforming to state Department Of Insurance guidelines.• Synchronized printing process across multiple departments. Developed resolutions into policies.• Created sophisticated workflow structure for IT and Business Units from initiation, creation, and user acceptance testing of new products.• Troubleshot and resolved incoming help desk issues, break/fix, and production support.• Code and migrate forms through development, test, model office, and production computer environments.• Work incoming help desk issues, break/fix, and production support for supported platforms.

• Knowledge of Enterprise Document Generation software. • Created, implemented, and maintained forms ensuring timely completion, ready to market.• Coded and migrated forms through development, testing, and modeling office environments.• Responsible for implementing all forms in a fast-paced environment.

• Worked closely with business units in coordinating project timelines. • Interfaced with customers to gather, assess and translate needs into effective solutions. • Researched and established complex information to deliver informed customer support.• Answering inquiries by clarifying desired information: explaining benefits, how claims were paid, and resolving problems by clarifying issues. Researching and exploring answers by developing creative alternative solutions and implementing those solutions.• Maintain call center database.• Review and explain medical bills received.• Determine covered medical insurance losses by studying provisions of policy or certificate.• Established proof of loss by studying medical documentation and assembled additional information as required from outside sources, including: claimant, physician, hospital, or other insurance companies. Initiating and conducted investigation of questionable claims.• Document medical claims actions by completing forms, reports, logs and records.• Resolving medical claims by approving or denying documentation, calculating benefits due, initiating payment, or composing denial letter.• Ensuing legal compliances by following company policies, procedures, guidelines, as well as state and federal insurance regulations.• Maintain quality customer service by following customer service practices and responding to customer inquiries.

• Establish proof of loss by studying medical documentation; assembling additional information as required from outside sources, including claimant, physician, hospital, or other insurance companies; initiating or conducting investigation of questionable claims.• Document medical claims actions by completing forms, reports, logs and records.• Resolving medical claims by approving or denying documentation; calculating benefits due; initiating payment or composing denial letter.• Ensuing legal compliances by following company policies; procedures; guidelines; as well as state and federal insurance regulations.

• Establish proof of loss by studying medical documentation; assembling additional information as required from outside sources, including claimant, physician, hospital, or other insurance companies.• Document medical claims actions by completing forms, reports, logs and records.• Resolving medical claims by approving or denying documentation; calculating benefits due; initiating payment or composing denial letter.• Ensuing legal compliances by following company policies; procedures; guidelines; as well as state and federal insurance regulations.

• Answered provider inquiries by clarifying desired information: Explain Benefits and verified eligibility.• Maintain call center database by entering information.• Document medical claims actions by completing forms, reports, logs and records.• Ensuing legal compliances by following company policies; procedures; guidelines; as well as state and federal insurance regulations.• Maintain quality customer service by following customer service practices; responding to customer inquiries.

• Supervised a team to match medical bills to files, enter them into a file tracking system, deliver all files to claims examiners.• Searched files in examining are to match mail.• Ensure all files were returned properly to file room.

• Match medical bills to files and deliver all files to claims examiners.• Searched files in examining are to match mail.• Returned all files properly to file room.