Quality & Training Specialist

Quality Assurance Specialist II
 Conduct call monitoring & Auditor evaluations against quality scorecards, and provide feedback & coaching recommendations to improve customer experience  Compile calls & information for facilitating internal & external partner calibrations to identify ways to improve and promote quality aligned scoring accuracy  Contribution to creating call center quality processes & procedure recommendations for enhancements to training materials as needed to enhance customer experience  Provide concise written analysis of the interaction along with feedback & coaching recommendations to improve the customer service representative’s performance  Recognized by senior leadership for initiating and delivering innovative quality assurance improvements to enhance best practices and subject matter expertise  Contributed by identifying areas for process improvement within standard operating procedures and guidelines, increasing efficiency and enabled richer collaboration among peers and customer experience  Established trust among peers as a go-to resource and mentor for QA questions, industry knowledge, and company standard operating procedures and guidelines
Customer Advocate I
 Organized member responses to inquiries from members/providers within established timeframes, and resolved member issues first call resolution
 Leveraging reference materials regarding benefits, authorizations, transportation, medications, provider searches and other health plan member inquiries
 Exceeded performance and quality standards based on established call center metrics including

Data Integrity Specialist
 Performed quality checks and audits of inbound & outbound calls including manual updates, to ensure adherence to policies, procedures and high level of customer experience and accuracy
 Identified trends related to incoming & outgoing calls including manual updates, which provided data analysis towards policy or process improvements to support improved customer service, quality improvement, first call resolution and including feedback on quality reviews to call center employees and management