Experience

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  Highpoint Digital

  • Lead Knowledge Resource Specialist

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  HighPoint Digital

  • United States
  • Business Consulting and Services
  • 200 - 300 Employee

  • Lead Knowledge Resource Specialist

    • 2019 - Present

    Consult with internal Continuous Improvement team and external partners to identify process improvements and enhance the customer experience.Analyze complex information from multiple sources to ensure accurate and compliant Training products.Stay updated on product knowledge, business trends, and policy changes.Collaborate with team members to identify process gaps and drive proactive product updates.Serve as an advisor to the Leadership team and participate in call-listening exercises and focus groups.

  • Quality Assurance Manager

    • Feb 2017 - 2019

    Managed a team of Quality Analysts, ensuring adherence to quality standards and performance targets.Developed QA processes and procedures to enhance efficiency and consistency.Created reports to track trends and drive quality improvement initiatives.Conducted performance evaluations and provided ongoing training to team members.

  • Lead Quality Analyst - Marketplace

    • May 2013 - Feb 2017

    Drive the creation of team processes, procedures and systems to ensure the highest levels of quality, consistency, compliance and customer satisfaction.Seek and recommend opportunities for process improvements and efficiencies.Lead and oversee projects within department and disciplines of expertise, including cross-discipline and cross-departmental projects.Manage communication of information within the team as well as to other teams, external and internal clients and other key stakeholders.Mentor and coach team members including facilitation of departmental on-boarding tasks and on-going team training needs.Act as first point of contact to team on questions and escalation issues.Develop job aids and reference materials on departmental processes for new and existing employees.Evaluate Health Insurance Marketplace inbound calls to determine if accurate and consistent information is provided to consumers while delivering excellent customer service according to CMS guidelines.Facilitate internal calibration sessions and participate in external calibration sessions with the client to ensure consistency in scoring principles.Ensure key client deliverables are completed in a timely fashion.Train new employees as needed.

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  Briljent

  • Senior Subject Matter Expert

    • May 2011 - May 2013

    Participate in the development and review of Medicare training materials and scripting to support Medicare's Beneficiary Contact Center (BCC) representativesUse Medicare knowledge and expertise to ensure that all training materials and scripting are accurate and complete and meet the standards for quality required by the Centers for Medicare & Medicaid Services (CMS)Work in design teams with Instructional Designers (IDs) and writers to develop materialsProvide Medicare subject matter expertise to support teammates in the creation of products covering all areas of MedicareMaintain currency of Medicare knowledge through ongoing research and review of program materialsResearch and validate materials, reviews Beneficiary Contac Center (BCC) interactions and make recommendations for improved TQC products and processes.Monitor phone calls and written correspondence for the Beneficiary Contact Center (BCC) and provide feedback and training recommendationsReview communications for the Centers for Medicare & Medicaid Services in the form of change requests and technical direction letters, and determine impact for the training, quality and content departmentConduct ad hoc training on Next Generation Desktop functionality for the Centers for Medicare & Medicaid Services new hires

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  Maricom Systems

  • Windsor Mill, Maryland

  • Quality Analyst/Trainer

    • Jun 2010 - May 2011
    • Windsor Mill, Maryland

    Responsible for the creation, deployment and implementation of all training materials for the Early Retire Reinsurance Program contact center. Conducted call monitoring on each Customer Service Representative to ensure accurate and complete information was provided to callers while adhering to the program's policies.Provided coaching, feedback and recommendations for 20+ contact center employees

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  Customer Value Partners

  • Windsor Mill, Maryland

  • Training Specialist

    • 2006 - 2010
    • Windsor Mill, Maryland

    Created and delivered training content for the Independent Quality Analyst contract for the 1-800-MEDICARE contact centerCreated and facilitated training assessments and provided feedback and training recommendations for staffFacilitated calibration sessions and managed the Email Quality Monitoring analystsMonitored phone calls and provided coaching, feedback and training recommendations for the 1-800-Medicare contact center

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  TrailBlazer

  • Timonium, Maryland

  • Customer Service Representative

    • 2005 - 2006
    • Timonium, Maryland

    Provided support to Medicare Providers on Medicare coverage guidelines and policies, and claims status including (but not limited to) claim location, denial reasons and payment amount. Also provided appeal status and information.

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  TrailBlazer Health

  • Timonium, Maryland

  • Claims Specialist

    • 2004 - 2005
    • Timonium, Maryland

    Processed electronic Medicare Part B claims, which required familiarity with ICD-9/10 codes, CPT codes, claim location and applicable audits, as well as Medicare coverage guidelines and policies. Determined whether claims should be approved or denied based on diagnosis codes, procedure codes and Medicare policies.