Heather Dixon2313 Stratford Ave Home: 724-255-8312Coraopolis, PA 15108 Cell: 724-255-8312

beilingh4447@gmail.com

SummaryDedicated employee with 8+ years of progressive customer service experience in a health care setting. Exhibit qualities of a vigorous self-starter working productively as part of a team or individually. Currently, I am seeking a new and challenging opportunity where I can utilize my experience to contribute to my future employer’s success.

Highlights

Meticulous attention to detail Client relations specialist Skilled multi-tasker Focused on customer satisfaction Microsoft proficiency Conflict resolution techniques Deadline-oriented Training and development

AccomplishmentsCustomer Service

Handled customers effectively by identifying needs, quickly gaining trust, approaching complex situations and resolving problems to maximize efficiency.

Investigated and analyzed client complaints to identify and resolve issues. Direct Liaison to Legacy Partners and National Distribution Partners to resolve benefit related inquires including but not

limited to enrollment status, formulary inquires, coverage determinations, and grievances for beneficiaries enrolled in Coventry Medicare products.

Traveled to Dallas, Texas with Sales Director to assist with on-boarding of new agency contract. Attended 2011 Health America member meetings to assist members with benefit related inquires in regards to their Health

America HMO/PPO Medicare Advantage Plans.Process Improvement

Oversaw implementation of agent appointment invoice process, and developed database to track all invoice payments. Created work flow documents for the Broker Services Department on all job functions related to the department. Managed readiness plans and lessons learned documents for senior management. Successfully created project plan to reduce commission payments on hold in excess of $5,000,000.00, and also eliminate the

backlog of holds on a go forward basis. Training/Certification

Successfully trained staff in all office systems and databases, policies and procedures while focusing on minimizing errors and generating superior results.

Completed onsite trainings for Distribution Partners on all commissions and contracting systems. Traveled to San Antonio, TX for 6 weeks to assist with training a new Member Services Department on the Medicare Part D

products, and issue resolution. Took lead and assisted with deployment of transition from Pinpoint LMS to AHIP LMS sites prior to Agent Certification Go

Live. Took lead and assisted with creating and maintaining Learning Management System, including creating Certification

Modules/Quizzes, reviewing all documentation for accuracy and CMS compliance, obtaining all approvals from department leads/management, and post deployment testing.

Research Took lead on Coventry’s internal audit of the Broker Services/Commissions Departments by obtaining all documentation,

completing all research, and providing all action items. Took lead on several projects within the department including but not limited to Distribution Partner/Agency contracting set

up, Coventry annual certification testing documents. Coventry’s Broker Portal online tool, App Tracker system enhancements, and Acom3 system enhancement deployment.

ExperienceImplementation Clerk 5/2015-PresentOxford Solutions (eBillingHub) Cranberry Township, PA

Complete firm vendor connectivity for all eBilling Vendor’s supported by eBillingHub. Review and complete all firm vendor connectivity tickets via ZenDesk. Create and upload expense codes, client lists, and Matter information. Support the Implementation Specialists with firm transition to electronic invoicing. Enhanced current excel reports for automation of data between multiple reports. Created Post Implementation Scorecard for automation in Share Point. Assisted Professional Services Department with deployment of the eBillingHub Certification program, including reviewing

slides, completing suggested edits, and testing system.

Sr. Analyst 11/2014-5/2015Aetna Health Care Moon Township, PA

Provided inventory reports to management. Develop processing documents for projects and enhancements for current processes. Review system enhancements prior to deployment by testing all new and current functionality for accuracy. Attended offsite Agent Contract requirement meetings to review yearly contract and CMS guideline changes to ensure

that all enhancements to commissions and contracting were compliant prior to Go Live. Assisted with yearly review of Broker Services website. This included creating project plan, reviewing and updating all

webpage content, and post deployment testing. Assisted with creating training modules for certification program. This included creating project plan, creating all

training documentation/quizzes, and post deployment testing. Taking lead on all audit requirements, including pulling all data to support audit findings. Create and manage project plans for all projects. Set up and lead meetings with all levels of management including internal and external customers. Onsite travel to Distribution Partners to review Commissions and Contracting systems.

Service Ops Supervisor 2/2014-11/2014Apria Health Care Canonsburg, PA

Manage a group of 20 staff members. Develop training plans for staff. Develop processing documents for projects and enhancements for current processes. Review quality and production goals for each staff member. Ensure that staff is trained and meeting production and quality goals. Set up and lead meetings with all levels of management including internal and external customers.

Service Ops Supervisor 01/2006-11/2013Coventry Health Care Moon Township, PA

Manage a group of 25 staff members. Managed phone staff of 18 in call center environment maintaining 30 second ASA, 3% abandonment rate, and 95%

Service level. Provide inventory reports to management, and assign daily queues to the staff. Develop processing documents for projects and enhancements for current processes. Review quality and production goals for each staff member. Ensure that staff is trained and meeting production and quality goals. Review system enhancements prior to deployment by testing all new and current functionality for accuracy. Set up and lead meetings with all levels of management including internal and external customers. Onsite travel to Distribution Partners to review Commissions and Contracting systems.

Information Administrator Completed inventory for the Broker Services department work queues for Senior Management. Created system enhancement documents and required testing prior to deployment. Assisted with all system enhancements prior to Annual Enrollment Period deployment including but not

limited to new commission rates, commission holds, certification requirements, and Agent Ready to Sell/Not Ready to Sell requirements.

Assisted with yearly review of Broker Services website. This included creating project plan, reviewing and updating all webpage content, and post deployment testing.

Assisted with deployment of new Learning Management System from Pinpoint to AHIP. This included participation in demo’s, creating project plan for deployment of new site, creating content, and post deployment prior to Certification Go Live.

Assisted with creating training modules for certification program. This included creating project plan, creating all training documentation/quizzes, and post deployment testing.

Created PowerPoint presentations for Coventry Health Plan Management meetings with departmental statistics, accomplishments, upcoming enhancements, and lessons learned.

Created PowerPoint presentations for Town Hall meetings with senior management and staff within the broker Services Department.

Onsite travel to Distribution Partners to review Commissions and Contracting systems.

Customer Service Associate (Associate, Specialist, Senior) Direct Liaison to Legacy Partners and National Distribution Partners to resolve benefit related inquires including but not

limited to enrollment status, formulary inquires, coverage determinations, and grievances for beneficiaries enrolled in Medicare Part D Coventry products.

Assisted team members within the Member Services Department with escalated issues, and questions.

Created workflow documents for the Member Services Grievance Department on all job functions related to the department.

Resolved member grievances and CMS completes by researching the beneficiaries’ complaints and outreaching to members with resolution.

Assisted beneficiaries enrolled in Coventry Medicare Part D products with benefit related inquires including but not limited to enrollment status, formulary inquires, coverage determinations, and grievances.

Assisted the Enrollment Department with keying of member enrollment applications, and issue resolution.

Training/Certification Microsoft Access 2007 1-3 AHIP Certified – Customer Service (2007) Microsoft Excel 2007 1-3 AHIP Certified – Understanding Medicare (2007) Microsoft Word 2007 1-3 AHIP Certified –Fraud, Waste, and Abuse (2008)

Education

Tiffin University 1999-2000Forensic Psychology Tiffin, OH