Sandy Gibson
Ventura
Summary
Seasoned Operations Expert with 18 years of successful experience within the Health Insurance Industry who employs organizational skills, interpersonal skills and computer data knowledge to effectively perform administrative and operational support duties with maximum impact. Consistently promotes company values and service standards for efficient office operations. Talented leader with an analytical approach to equipping employees to independently handle daily functions and meet customer needs.
Overview
18
18
years of professional experience
Work History
Operations Expert
Elevance Health
05.2022 - 08.2023
- Training new hires,
- Teaching Upskilling classes to new hires,]
- Repeat caller documentation,
- Analyzing documents and data for repeat callers
- Operations expert for a specific unit
- Coached representatives
- Audited calls
- Gathered data on reps calls for coaching
- Served as a first line resource for operation associates for workflow and technical related processes,
- Provided operational training
- Assisted associates by answering day-to-day questions
- Encouraged an environment driven by teamwork
- Monitored inventory to ensure workflow remained uninterrupted
- Handles complex case research and resolution for management
- Improved customer satisfaction by resolving issues promptly and maintaining high standards of service delivery.
- Ensured compliance with relevant regulations and industry best practices through thorough documentation and reporting.
- Reviews, interprets, and maintains records of service level, quality, accuracy, and productivity,
- Reviews department policy and procedure manuals for accuracy,
- Works with representatives after training to ensure procedures and policies are accurate, complete and implemented
- Identified areas for improvement through regular audits, recommending process enhancements that ultimately led to increased profitability.
- Collaborated on operational support tasks to achieve common goal.
- Tended to urgent correspondence to facilitate communication or resolution.
Customer Service II, III
Anthem Blue Cross
07.2005 - 05.2022
- Experience with enrollment and billing/ membership, Keying claims/ forwarding correspondence
- Answering phones and responding to escalated inquiries,
- Follow up experience with claims and auditing accumulators
- Multi-tasking while on the phone and documenting calls
- Acting Operations Expert support for internal reps
- Acted as Subject Matter Expert in Training classes and created new material
- Handled inventory/ audits / follow up
- Working side by side with Operation Experts and teaching our reps new processes and systems
- Experience with ISG and Large Group,
- CALPERS
- SISC,
- LAPRA
- LACERA
- LACERS
- COLA
- Subject Matter Expert for Large group inventory and chat support
- Part of our Change Ambassador Team
- Managed a high volume of inbound calls while maintaining a professional demeanor under pressure.
- Resolved customer complaints with empathy, resulting in improved satisfaction ratings.
- Assisted customers in navigating the company website or mobile app for self-service options when applicable.
- Maintained up-to-date knowledge of company policies, procedures, and promotions for accurate information sharing.
- Collaborated with team members to improve overall response times and service quality.
- Negotiated successful resolutions between customers and the company during disputes or disagreements.
- Enhanced customer experiences by providing timely and accurate information on products and services.
- Served as a liaison between customers and other departments within the organization, ensuring seamless coordination in addressing client needs.
- Reduced wait times by implementing effective call routing strategies.
- Delivered personalized recommendations based on individual customer needs, driving sales growth.
- Streamlined communication processes for increased efficiency in addressing customer inquiries.
- Developed rapport with customers by actively listening and empathizing with their concerns.
- Resolved customer complaints, leading to increased satisfaction ratings.
- Contributed to positive work environment by consistently exceeding team goals through collaborative efforts.
- Implemented feedback mechanisms, which led to significant improvements in service delivery.
- Assisted customers in navigating company's products and services, enhancing their overall experience.
- Conducted comprehensive training sessions for new hires, ensuring high level of service quality.
- Monitored and analyzed customer service metrics to identify areas for improvement.
- Facilitated smooth communication channels between customers and various departments, ensuring customer needs were promptly met.
- Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
- Responded proactively and positively to rapid change.
- Met customer call guidelines for service levels, handle time and productivity.
- Educated customers about billing, payment processing and support policies and procedures.
- Maintained up-to-date knowledge of product and service changes.
- Cross-trained and backed up other customer service managers.
Education
Associates in General Liberal Arts -
Ventura College
Ventura, CA06.2005
Associates in Criminal Justice -
Ventura College
Ventura, CA06.2005
Diploma -
Buena High School
Ventura, CA06.1999
Skills
- Customer Service
- Healthcare industry understanding
- Claims Processing
- Team Leadership
- Quality Assurance
- Problem-solving abilities
- Active Listening
- Critical Thinking
- Problem Resolution
- Call center experience
- Computer Proficiency
- Conflict Resolution
Timeline
Operations Expert
Elevance Health
05.2022 - 08.2023
Customer Service II, III
Anthem Blue Cross
07.2005 - 05.2022
Associates in General Liberal Arts -
Ventura College
Associates in Criminal Justice -
Ventura College
Diploma -
Buena High School
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