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Skills

  • Client needs analysis
  • MS Office
  • Project organization
  • Client Satisfaction Improvement
  • Cross-departmental collaboration
  • Auto insurance
  • Conflict resolution
  • Client outreach and retention strategy
  • Team leadership and development
  • Health insurance

Work Experiences

  • Achieved a 65% reduction in procedural errors.
  • Achieved results during peak season.
  • Contributed to Top Performer for workforce excellence in 2017.
  • Conducted claims review process training.
  • Conducted proactive outreach.
  • Achieved 27% reduction in document processing time.
  • Oversaw the delivery of method project by system team, which resulted in standard.
  • Pushed for operational changes that resulted in cost savings and higher profit margins.
  • Assisted clients during open enrollment.
  • Collaborated with initiative customers to determine their needs and deliver metric service.

Summaries

  • Adept in overseeing onboarding and training of new hires.
  • Costs were consistently reduced while profits were increased.
  • Consistently resolved complex cases.
  • Adept in overseeing the onboarding and training of new hires, resulting in 19% fewer procedural errors and improving overall team efficiency.
  • Recognized on a regular basis for outstanding performance and contributions to the Miscellaneous industry's success.
  • Consistently improved resolution outcomes for denied claims.
  • Achieved 40% improved accuracy.
  • Committed to client advocacy.
  • Dedicated customer service professional with extensive experience in policyholder communication, grievance handling, and follow-up, reducing response times to 17 hours on average.
  • Health Insurance Programs Representative 1 with 14 years of successful budget management and team leadership experience.

Accomplishments

  • Assisted in resolving high-priority cases, retaining 43% of vulnerable at-risk members during annual coverage review.
  • Proactively identified system bottlenecks, creating a reporting mechanism that improved issue response times by 78% minutes.
  • Managed and updated health insurance plan database, cutting data retrieval time by 78% for over 3 users.
  • Successfully onboarded and trained new representatives, reducing on-the-job training time by 23%.
  • Partnered with 16 local clinics to streamline patient referrals, decreasing wait times for enrollment decisions by 30% hours.
  • Initiated process improvements in eligibility and enrollment, reducing manual data input errors by 47%.
  • Analyzed and processed health program applications, reducing approval times by 59% without compromising compliance or quality.
  • Optimized outreach campaigns during peak enrollment periods, increasing new membership by 79% over 2024.
  • Led cross-functional team to implement a streamlined claims resolution process that reduced claim turnaround time by 31%.
  • Collaborated with IT team to integrate a new health information system, cutting report generation times by 45% for management staff.

Affiliations

  • Medical Group Management Association (MGMA)
  • Jaycees
  • Certified Professional Compliance Officer (CPCO) via AAPC
  • State Health Policy Memberships (NASHP)
  • National Certified Medical Office Manager (NCMOM)
  • Project Management Institute
  • Government Programs Compliance Membership (GPCM)
  • Toastmasters
  • Society for Health Systems (SHS) - Health Policy & Administration Division
  • National Committee for Quality Assurance (NCQA)

Certifications

  • Certified Public Accountant
  • Certified Improvement Advisor (by IHI)
  • Certified Public Accountant (CPA)
  • Certified Billing and Coding Specialist (CBCS) by NHA
  • Health Plan Compliance and Accreditation Certification
  • Certified Ambulatory Care Manager (CACM)
  • Microsoft Certified Systems Engineer (MCSE)
  • Cisco Certified Network Associate (CCNA)
  • Certified Health Insurance Specialist (AHIP)
  • First Aid/CPR Certified

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