Consuelo Duran

Quality Monitor, June 2013 – March 2024

Analyzed recorded interactions between beneficiary, consumer, and customer service representatives.

Delivered constructive feedback through quality monitoring notes and coaching sessions.

Utilized approved training materials, job aids, and scripted information for CSRs to reference during future similar calls.

Achieved and exceeded daily evaluation quotas.

Maintained compliance with CMS Quality Assurance.

Oversaw inbound calls during peak periods, including Open Enrollment Period.

Executed processing of enrollments into Medicare and Marketplace plans.

Medicare Internal Support Group (ISG) August 2011 - June 2013

Supported Customer Service Representatives to effectively utilize Next Generation Desktop (NGD).

Guided CSRs in identifying relevant scripts to enhance responses to beneficiary inquiries.

Managed redirected Supervisor calls.

Medicare Customer Service Representative, Beneficiary Contact Center, May 2008 - June 2013.

Resolved beneficiary inquiries and concerns through utilization of approved scripted information.

Investigated beneficiary claims details related to services rendered.

Executed functions and responsibilities of Tier 2, MBS, Claims Part A Tier 2, Claims B Tier 2, and Durable Medical Equipment (DME) Tier 2.