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Malougen O.

Customer Service & Operations Specialist | QA Specialist | Insurance Claims Processor

Verified
$10/hr

Outline

Looking for Full-Time work (8 hours/day) at $10/hour

Bachelor's Degree

English proficiency Fluent

Professional Summary

15+ years the BPO industry, with strong skills in problem-solving, compliance, process improvement, and customer-focused service delivery.

Skills & Experience

Skills

Communication Skills 10+ Years
Critical Thinking 10+ Years
Call Handling 10+ Years
Accurate Data Entry 10+ Years
Customer Experience Management 10+ Years
Process improvement 2-5 Years
Quality Assurance 2-5 Years
Calibration 2-5 Years
Claims Processing 5-10 Years
Fraud Detection 5-10 Years
Problem -Solving Skills 10+ Years
Performance Coaching 2-5 Years
Claims Processing (Benefits & Eligibility) 5-10 Years
Cross-Functional Stakeholder Communication 5-10 Years
Auditing and Compliance Monitoring 2-5 Years

Experience highlights

Customer Service Associate
Newstel GmbH (eCommerce-Remote) · January/2025 – Present
Answered product inquiries, resolved post-transaction customer issues such as payment status, tracking status, order discrepancies, cancellations, and refunds via phone, chat, and email within standards and SLA timelines, while processing account updates accurately in a high-volume environment and maintaining CRM data integrity.
Quality Assurance Analyst
Newstel GmbH (eCommerce-Remote) · April/2022 – Present
Evaluated customer interactions across calls, emails, and chats against quality standards, identifying error patterns and root causes to drive process improvements and reduce compliance issues and escalations. I led calibration sessions, used Evaluagent and Google Sheets for performance analysis, facilitated QA coaching, contributed process improvement recommendations, and served as OIC overseeing workflows and reporting to the Account Manager.
Sales Representative
Newstel GmbH (eCommerce-Remote) · March/2018 – Present
Managed outbound customer interactions to resolve abandoned carts and pre/post-purchase concerns, drive sales conversions, and support customer retention through clear, solution-oriented communication. Applied strong product knowledge to resolve issues and meet targets in a high-volume environment, while conducting retention outreach and maintaining accurate CRM records.
Level 2 Claims Processor
RR Donnelley Phil.s. · March/2012 – Present
Managed end-to-end insurance claims processing (A&H, Critical Illness, Overseas Secondment and AMEX NAC), including documentation review, coverage assessment, dispute resolution, and settlement decisions within SLA standards. Identified potential fraud, coordinated with stakeholders for claim resolution, handled escalations, and served as OIC overseeing workflows and reporting to management.
Technical & Customer Support Representative
Teletech (Verizon) | Convergys (AT&T) | VXI Global (Vonage) · November/2005 – Present
Delivered high-volume inbound and outbound customer support across telecommunications accounts in various BPO companies, resolving technical and service issues through structured troubleshooting. Provided clear, patient, and solution-oriented communication for complex customer concerns while maintaining accurate CRM documentation and consistently meeting KPIs for first-call resolution, customer satisfaction, and call quality.
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