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- 1. 907 MOOSIC STREET SCRANTON, PA 18505 570.904.4969 PHENZL@YAHOO.COM ~ Data Collection, Research & Analytics ~ PROFILE OF QUALIFICATIONS  Offering 17 years of diverse Health Insurance administrative experience with special focus on customer and client care  Highly focused individual capable of managing the ongoing tasks of large projects as well as managing employees  Detail oriented with an eye for improvement and streamlining; dedicated to boosting company success through superior service  Extensive experience working with all Microsoft Office programs along with working knowledge of many specialized and homegrown applications  Excellent organizational and presentational skills along with the ability to multitask PROFESSIONAL EXPERIENCE TMG Healthcare – Scranton, PA 2002-2015 Testing Analyst III C.T.F.L • Throughout the last 12 years has had experience with all the Services TMG performs for every client; has been exposed to all of the clients that TMG services as well as has a working knowledge of almost every application TMG utilizes • Obtained in-depth knowledge of the System Development Life Cycle from over 8 years of Testing Analyst experience; gaining a comprehensive understanding of functional & business requirements and of technical design and mapping documentation • Proven ability to effectively formulate test plans and strategies; as well as can efficiently prepare and execute test scripts • Constantly looking for creative ways to improve processes by leveraging the few tools that were available such as SQL and Excel to increase proficiency to work smarter by cutting down the number of manual tasks that could be performed systematically • Previously managed up to 40 employees in the claims and customer service departments where duties included but were not limited to: Quality checking employees’ work, performing monthly and yearly reviews, tracking and organizing employee records, recording attendance, submitting per piece payroll through HR and hourly employees payroll through ADP; initiating disciplinary action when deemed necessary, providing constructive criticism, coaching and up-training • Specializing in customer and client service, consistently providing high levels of service and resolving all issues and inquiries with courtesy; devoted superior attention to customer feedback and quality control • Continually working with various teams by identifying inadequacies in various procedures and contributing suggestions on how to improve them along with assisting in documenting departmental policies and procedures; creating many personal job-aids/workflows that have been shared freely with my coworkers • Thoroughly understands of all types of insurance coverage ranging from Individual and Group Commercial plans to Medicare, Medicaid and dual products • Received many positive reviews and customer feedback as well as received awards & recognition for hard work and dedication from TMG and from one of TMG’s most demanding clients Cigna Healthcare – Scranton, PA 2000-2002
- 2. Customer Service Representative II • Expertly compiled data from seven separate databases to provide benefit, claim, and eligibility information in an extremely fast-paced, stressful and constantly evolving environment • Received a 6-week training course which provided a thorough understanding commercial insurance guidelines along with each commercial insurance plan structures and how they differ from each other. It also provided in depth details on how to translate the specific verbiage provided in the benefit summary for each benefit category • The training course also covered how all of these commercial plan types Coordinate Benefits with each other and/or how to establish any third party liability • Worked closely with members, providers, and clients to ensure satisfaction and a high level of personalized service as efficiently as possible without sacrificing quality • All employees were closely monitored to ensure performance metrics such as average talk time, handling time and hold time met office standards and their monthly Call Quality average of 95% or above is achieved; as well as employees’ break, lunch, facility and any non-call times were carefully tracked as employee availability was expected to be 97% of their shifts or above with a schedule adherence of 90%. If any of the above referenced metrics were not met that month progressive action was taken. Mercy Hospital – Scranton, PA 1999-2001 Admissions Clerk • Main position held was Inpatient Admissions with following job responsibilities: o Room inventory and maintenance which included supervising the cleaning crew to ensure when discharges occurred that every room was promptly cleaned and readied for incoming patients while guarding their break/lunch times o Kept all departments up-to-date with detailed communications in order to provide for the routing and care of all patients o Responsible for assigning beds based on the patient’s diagnosis and the floor’s staffing resources o Calling the patient’s insurance company to pre-certify admissions o During slower periods pre-registering patients & creating charts for various outpatient treatment and services EDUCATION Penn State University Associates, Liberal Arts: Science & Humanities; 2002 REFERENCES Name: Mrs. Sarah Franchetti Relationship Type: Professional / I worked with her at TMG Health Phone/Contact: She is now Director, Healthcare Industry Principal at Pegasystems Name: Mrs. Jill Grogan Relationship Type: Professional / I worked with her at TMG Health Phone: 570 344 9237 x 73051 Name: Ms. Linda Crambo Relationship Type: Professional / I worked with her at TMG Health (she no longer works there) Phone: 570 212 0470 Name: Miss Ashley Wilson Relationship Type: Professional / I worked with her at TMG Health Phone: 570 954 0551