Quality Supervisor Resume BATON ROUGE, LA - Hire IT People

SUMMARY:

Accomplished leader with more than five years of high - volume Confidential expertise and a reputation for ‘getting the job done’.
Passionate about exceeding expectations and achieving winning outcomes for both employees and customers.
Acknowledged for pioneering employee development programs that create confident representatives that provide seamless Confidential experiences.
Reshaped the new hire training process and organized learning materials to broaden employee knowledge base and increase productivity of Confidential .
Staff Training and Development
Conflict Resolution
Inbound/Outbound Calls
Procedural Improvements
Quality Call Monitoring
Confidential
Leadership and Team Building
Employee Relations
Discretion and Ethics

PROFESSIONAL EXPERIENCE:

Confidential, BATON ROUGE, LA

Quality Supervisor

Responsibilities:

Perform quality assurance audits and assessments on Quality Assurance Analyst to ensure defined goals set for monitoring calls are met and compliance of evaluation procedures.
Recognize areas of improvement during call monitoring and develop action plan to improve staff performance and efficiency.
Provide corrective actions to Confidential team when quality of call is scored less than satisfactory.
Utilize quality progress reports to identify weak areas of the Confidential and recommend solutions and assist management team with update call flow procedures.
Created new Claims Training Guide, facilitate new hire Confidential training, ensure representatives are educated on company Confidential policy and procedures.
Promotes positive reinforcement by taking advantage of The Employee Incentive Programs. Act as a mentor to those employee seeking career advancement and encourage openness and transparency with an open door policy.

Member Advocacy Supervisor

Confidential

Responsibilities:

Coordinated documentation, tracking and resolution of all member and provider issues. Implemented work processes for staff to resolve known member and provider issues.
Established a community presence, promoted member education, identified and resolved any systematic barriers that limited members’ access to appropriate care.
Managed staff attendance and addressed staff concerns. Administered staff performance reviews and identified improvements.
Prioritize and assign work load. Monitor task status and updates via Customer Relationship Management (CRM) system. Ensured Member Advocates adhered to established complaints and appeals policies and conducted training to bridge staff knowledge gaps.

Confidential Supervisor

Confidential

Responsibilities:

Collaborated with management team to develop successful actions plan to meet the company’s overall business goals and objectives for the Confidential and Confidential Representatives.
Headed small group trainings on new plan information, career development, and Confidential skills.
Reviewed processes to ensure compliant with contractual agreements and State and Federal Regulations.
Compiled daily reports to monitor phone logs, work-flow issues and trends.
Analyzed reports and provided resolutions to management.
Proactively monitored calls for call quality. Responded to complex issues.

Team Leader

Confidential

Responsibilities:

Handled, investigated, and resolved complex claim matters.
Delegated as Health Plan subject matter expert; providing information about claims, eligibility, covered benefits and authorization status matter.
Identified trends related to members and/or providers inquiries, provided feedback to management and recommended proactive solutions to decrease repeat inquiries.
Increased Confidential productivity by training representatives to provide first call resolution and encouraging a ‘own the call’ mentality.
Transformed morale of Confidential by acknowledging positive behaviors.

Confidential

Representative

Responsibilities:

Recognized for exceptional ability to handle inbound and outbound calls.
Responded to members and providers inquiries via telephone and written correspondence within established time frame utilizing current reference materials and available resources.
Documented all activities for quality and metrics reporting.
Constantly exceeded performance and quality standards established on Confidential metrics.
Researched and identified any processing inaccuracies in claim payments.