Experience

AgeWell New York Company Page

• United States
• Wellness and Fitness Services
• 1 - 100 Employee

• Call Center Manager

  • Jan 2017 - Present

  • Manage a team of customer service representatives, proving leadership, guidance and support to guarantee that member needs were met and exceeded.• Responsible for interviewing prospective employees.• Review call metrics using the Mitel system to ensure compliance with Federal entities and company requirements.• Strategize to guarantee 80% of calls were answered <30 seconds and maintain an abandonment rate of <5%.• Handle member complaints and resolve issues to avoid/reduce disenrollments.• Research rules and regulations based on CMS guidelines and implement them accordingly.• Collaborate with IT department to troubleshoot technical issues.• Conduct monthly audits on delegated entities to report quarterly.• Conduct internal audits on phone system and call center representatives.• Review CMS & State websites to ensure most up to date information is being provided to members.• Work closely with corporate compliance. Resolve and report any discrepancies discovered.• Collaborate with marketing team to develop strategies targeted to increase member satisfaction and retention.• Prepare staff for Annual Enrollment Period and CMS test call season.• Create visual and physical training materials for representatives to reference using Microsoft software.• Create CAP (Corrective Action Plan) training to re-educate staff.• Conducted regular member check-ins and reviews using Tableu software, to assess member satisfaction and identify opportunities for improvement.• Worked with cross-functional teams to resolve complex member issues.• Create SOPs to serve as a blueprint and guide employees on how to perform daily tasks based on CMS and Organization requirements.• Demonstrated strong problem-solving and communication skills, with the ability to communicate effectively with members and staff at all levels.• Educate members on programs offered by the state that pay for medications, copays, deductibles & coinsurance fees. Show less

• Call Center Supervisor

  • Jan 2015 - Jan 2017

  Trained, managed & mentored 10+ full-time employees.• Conducted performance reviews monthly to guarantee member satisfaction was prioritized and organizational requirements were met.• Collaborated with the Medicare Enrollment department processing enrollments and disenrollments based on CMS guidelines.• Audited disenrollments.• Reviewed member data to determine causes for disenrollments and create strategies to retain members.• Trained employees across the organization on new policies and procedures.• Developed educational tools to help representatives assist members efficiently.• Monitored the employee calendar to ensure accurate staffing.• Reviewed call metrics using the Mitel system to ensure compliance with Federal entities and company requirements.• Tested IVR on a weekly basis and when issues occurred to guarantee compliance with CMS.• Created weekly/monthly reports of incoming calls to update upper management and educate them on areas of improvement.• Worked closely with other departments to ensure customer satisfaction. Show less

• Member Services Representative

  • Jul 2013 - Jan 2015

  • Provided accurate, prompt & courteous service in response to written and telephonic inquiries from members and providers.• Processed member grievances and appeals according to organizational standards.• Provided translation as needed.• Worked on special projects of the member service department.• Used computerized systems for tracking and information gathering.• Supported members gathering the necessary forms and information for a Medicaid application by making home visits.• Worked with current/potential members filling out/following up on new Medicaid applications/recertification.• Informed and educated current/potential members about the different lines of business offered by the organization.• Explained enrollment process and benefits of joining a part c plan to new Medicare enrollees.• Verified and documented Medicare information according to state and Federal requirements.• Validate and input Medicare application before submitting to CMS. Show less