Summary
Overview
Work History
Education
Skills
Timeline
Generic

Michelle Ratley

Pittsburgh

Summary

Focused professional with 22+ years of experience and a proven knowledge of customer communications, productivity and performance management, and confidential correspondence. Aiming to leverage my skills to successfully fill the Customer Service Representative role at your company.

Overview

25
25
years of professional experience

Work History

Quality Analyst

Accredo
12.2020 - Current
  • Perform independent and consistent audits of moderate complexity to determine the accuracy, compliance and consistency of all operational activities against the corresponding procedures.
  • Operational activities include - Telesales, call handling, email handling, claims processing.
  • Perform root cause analysis on every audit error to understand why the error occurred. Agrees to suitable action plans to remove root cause and prevent errors from recurring.
  • Monitor performance trends and agrees suitable action plans to address these trends.
  • Identify improvements to both audit and operational processes and procedures.
  • Collate and report audit findings to Senior management accurately and on time.
  • Assist in the development of audits and audit processes and procedures.
  • Act as a subject matter expert who supports and coaches their fellow auditors.

Customer Service

Zulily
07.2022 - 12.2023
  • Demonstrated excellent communication and interpersonal skills to ensure customer satisfaction.
  • Utilized problem-solving abilities to identify solutions to customer issues and provided appropriate follow-up actions.
  • Researched relevant materials to provide comprehensive answers for customer questions.
  • Developed strong rapport with customers by actively listening to their needs and responding promptly to inquiries.
  • Provided accurate resolutions to customer inquiries in a professional and courteous manner.
  • Answered incoming calls promptly, professionally greeting each caller.
  • Spoke clearly and persuasively in positive or negative situations, listening to customers to get clarification and respond to questions.
  • Reported trends, issues, and feedback learned from customer interactions to support continuous improvement.
  • Answered inbound calls to handle customer inquiries, complaints and billing questions.
  • Performed data entry tasks accurately and efficiently using multiple systems.
  • Tracked customer orders and provided updates on delivery timelines as needed.
  • Engaged with customers to identify service needs and determine appropriate offerings.
  • Directed inbound calls in phone queues to improve call flow.
  • Utilized problem-solving techniques to identify solutions for customer complaints.
  • Answered customer inquiries promptly and professionally via phone, email, and chat.
  • Utilized effective communication techniques to provide accurate information to customers.
  • Analyzed customer feedback data to identify trends in customer satisfaction levels.
  • Updated customer account information accurately in the database system.
  • Gathered relevant data from customers to accurately route calls or emails to the appropriate department.
  • Provided technical support to customers with product issues.
  • Monitored incoming calls and emails and ensured that they were routed appropriately.
  • Applied problem-solving skills to resolve customer complaints efficiently.
  • Adhered to established policies when responding to customers' inquiries.
  • Evaluated customer needs, identified solutions, and offered recommendations for further action.
  • Provided information about products or services to customers by answering questions via phone or email.
  • Documented procedures related to the handling of customer issues.

Quality Analyst

Cigna
02.2003 - 12.2020
  • Responsible for new hire orientation.
  • Perform visual audits
  • Inspected packages post ship to ensure accurate paperwork and product to ensure compliance to Client and Cigna requirements.
  • Reported results to Pharmacy Operations and the Quality Manager.
  • Conducted an inspection of each Kirby Lester counting tool to ensure each tool is counting properly on a quarterly basis and clean machines as necessary to ensure accurate operation.
  • Ensure adherence to client contracting as it relates to performing internal auditing and quality improvement by ensuring that the proper number of inspections get completed each quarter on time as required.
  • Perform audit on pharmacy technicians ensure that prescriptions are translated and entered correctly
  • Performed audit to ensure technician entered prescription per state regulations.

Customer Service Representative

Cigna
10.2000 - 02.2003
  • Coordinate and ensure services are covered under insurance coverage and talk to patients about their deductibles, co-payments, and authorizations.
  • Interact directly with healthcare providers. Research issues on benefits coverage with pharmacist and doctors' office and provide guidance to patients about medication coverage.
  • Translate prescriptions filled out by the prescriber and enter information in the patient's profile in accordance with state regulations.
  • Research current and past prescription orders.
  • Maneuver through several different systems.
  • Process overrides and work exceptions on prescription orders.
  • Serve as SME and assist with questions/issues for team members in coordination with supervisor.

Education

High School Diploma -

Trinity
Washington, PA
06.1988

Skills

  • MS office (Access)
  • Excellent communication skills
  • Ability to work independently

Timeline

Customer Service

Zulily
07.2022 - 12.2023

Quality Analyst

Accredo
12.2020 - Current

Quality Analyst

Cigna
02.2003 - 12.2020

Customer Service Representative

Cigna
10.2000 - 02.2003

High School Diploma -

Trinity

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Michelle Ratley