Yvette De Costa-Smith has over 13 years of experience in customer service and administrative roles in the healthcare industry. She is currently a Team Leader Call Center at Royal Health Care, where she supervises customer service representatives and monitors calls for accuracy. Previously, she was a Client Service Manager and Quality Analyst/Administrator at Royal Health Care, where she handled client issues, ensured accurate claim processing, and assisted with training. She is proficient in Microsoft Office, healthcare databases, and call center software.

1. Yvette De Costa-Smith
To contribute acquired administrative and customer service skills to a position that is challenging in which would
provide corporate growth.
EXPERIENCE: 4/2016 -Present
Royal Health Care, LLC
CA Plaza Ste 400
Islandia, NY 11749 (631)-881-2494
Pela Chacon, Director
Team Leader Call Center
Duties: Responsible for providing supervisory support to the customer service reps. It involves problem
solving and troubleshooting issues in the call center. A vital part of my job was to assist in monitoring calls
for accuracy as well as following up on claim adjustments, check runs and preparing daily reports. I also
make recommendations for the departments improvement in which involved (Tip of the Day). I supply
providers with information on member eligibility and claim status. I am responsible for providing members
and providers with dental eligibility and claim status. This also involved pre-estimate status providers
requested on a member’s pre-approved dental work. I track all calls incoming and outgoing on a daily
basis. Coordinate departmental monthly meetings. Oversee maintenance of departmental library and
training manuals. Assist with updating, writing, and maintaining departmental Policies and Procedures.
Coordinate training and new hire set up. Provide support for newly trained Provider Service Advocates;
provide customer service guidance; make recommendations to develop training plans and improve upon
existing plans. Assist with performance coaching (on the job training, questions from the staff) and provide
feedback to the Supervisor. Identify trends/issues/deficiencies within the Provider Services Department;
make recommendations for modifications and /or improvements. Keep management informed of issues
adversely impacting service levels; suggest and /or implement corrective action. Assist with customer calls
during high volume periods. Assist with IVR implementation and testing. Complete miscellaneous
assignments upon request. Ensure compliance with Company policies and procedures, NYS, federal and
HIPAA guidelines and regulations.
1/2015 -3/31/2016
Royal Health Care, LLC
CA Plaza Ste 400
Islandia, NY 11749
Jackie Ahen, Executive Manager
Client Service Manager
Duties: Maintain excellent rapport with clients, internal and external to drive timely resolution of client
issues. Demonstrate strong sense of urgency ensuring quick remediation of client issues/concerns.
Actively communicate and document progress and deliverables through resolution to client.
Handle the client’s implementation and maintenance issues ongoing for client. Proactively analyze and
determine client retention risk and escalate to senior management to mitigate risks. Identify and involve
appropriate resources to manage execution of client processes and timely delivery of company’s services.
Leverage knowledge and experience to develop appropriate solutions that increase value to our
organization and benefit client. Facilitate and lead client conference calls and visits to address service
delivery expectations, review of deliverables and issue resolution. Ensures that all processes and
procedures are completed, quality standards are met, and timely deliverables of projects. Coordinate the
production of reports and ensure timely delivery to client, vendors and regulatory agency as requested by
client.
2/2003 -12/2014
Royal Health Care, LLC
CA Plaza Ste 400
Islandia, NY 11749
Robin Newman, Director
Quality Analyst/Administrator
Duties: Responsible for assuring the accuracy, completeness and appropriateness of claim determinations
and payment for all Medicaid clients. Knowledge and understanding of CPT & ICD9 coding, Emdeon Clearing
House, DRG, APC, APG and Mental Health pricing methodology which are programmed appropriately per
contractual agreements with abiding by state guidelines. Securing fee schedules are loaded timely and
accurately, as well as providing support and education to the staff as necessary. Audit and analyze a
variety of claim samples including auto-adjucated claims to assure correct coding guidelines are per meet
per Medicaid and Medicare. QA claim data to identify root cause of incorrect claim reimbursement and
determine appropriate action to minimize future errors. Identify and communicate trends observed in
order to introduce and/or revise policies and procedures necessary to improve staff processes and
performance as recommended. To report quality scores based on individual and departmental
performance. Assist in training the team on client and system information. Assist the staff and providers
in answering supervisor calls from the call center. Maintain and compile individual, departmental and client
quality data. Maintain materials utilized in the training of new and established employees on a regular
basis.
EDUCATION: 8/1984 - 6/1986 SUNY Old Westbury, NY-Westbury Currently attending SUNY Canton
POHS Institute Certificate of Completion in Sale Health Insurance
SKILLS: Windows 98, MS-DOS, Microsoft Word, Excel, Power Point, WordPerfect, Access, Act Database,
Online Access, MAC, Txen, QDX, Call Tracking, Switchboard.
Professiona
l
Qualificatio
ns and Key
Strengths:
Professionally
Result-oriented
with excellent
communication
and interpersonal
skills.
Accurately
perform
challenging tasks
with precision
and attention to
detail. Excel at
organizing,
troubleshooting
and taking
adverse situations
& making them
positive.
Recognized for
professionalism,
positive mental
attitude, and
commitment to
excellence.
Demonstrated
ability to
communicate and
interact with
individuals from a
wide range of
social and
cultural
backgrounds.
Excellent written,
verbal,
presentation and
computer skills.
Proficient in
problem solving,
with the ability to
quickly adapt to
the unexpected.
Valued by
superiors for
work ethics and
open-mindedness

2. 33 Hyde Lane Coram, NY 11727
631-881-2479 – Work 631-772-7617 - Home 631-464 -1884 - Cell EV32765@hotmail.com - Email