MS Office
Lacey Spurlin
Director Of Claims
Indianapolis,IN
Summary
Director driven to achieve results through strategic planning and professional relationship building. Motivated to create operational efficiencies by implementing lean processes, striving for automation, and thinking outside of the box. Dedicated to building strong teams within an organization through motivation, strong development, and good hiring practices.
Overview
16
16
years of professional experience
10
10
years of post-secondary education
Work History
Director of Claims
SIHO Insurance Services
Columbus, IN
03.2020 - Current
- Assisted in new Medicare Advantage product implementation and development of processes.
- Effectively oversee Claims and Claims Services Departments consisting of 31 individuals, including Claims Analysts, Claims Services Specialists, Supervisors and Manager.
- Summarize results, identify opportunities for efficiency and improvements in order to make recommendations to Executive Team.
- Ensure departmental quality standards are upheld and claims are processed consistent with client and corporate policies, procedures, best practices and regulations.
- Compiled documentation and prepared Control Activities for SOC 1 Audit.
- Created Training and Onboarding Program for new hires.
Director of Claims Services
SIHO Insurance Services
Columbus, IN
03.2016 - 03.2020
- Managed inventory for Electronic, Keyed from Image (KFI), and Repricing claims to ensure 3- day turnaround time.
- Implemented audit program to guarantee quality of work.
- Reduced KFI inventory by 94% and Repriced Claims inventory by 82% by implementing standardized procedures and allocating resources.
- Presented departmental updates to Senior Staff team on regular basis.
Manager of Fully Insured Product
SIHO Insurance Services
Columbus, IN
03.2015 - 03.2016
- Created processes for client’s new product, resulting in implementation of 75 fully insured groups- with over 4,000 members.
- Participated in Rapid Process Improvement Initiative with client to enhance and create lean processes for all commercial group implementations.
- Cultivated project timelines, documentation, processes and updates to develop and manage implementations.
Manager of Eligibility and COBRA
SIHO Insurance Services
Columbus, IN
03.2014 - 03.2015
- Established audit processes to decrease manual errors and increase quality.
- Enhanced eligibility and COBRA files to allow automation into system, resulting in less time spent on processes and reduced chance of manual error.
- Worked with Client and Health Exchange platform vendor to implement new on- and off-exchange product, resulting in over 10,000 subscribers.
- Assisted in converting to new claims processing system.
Staff Accountant
SIHO Insurance Services
Columbus, IN
02.2013 - 03.2014
- Reconciled over 70 company and external client cash accounts on monthly basis.
- Uploaded daily check runs into vendor system to print checks, RAs, and EOBs.
- Posted journal entries in financial software and imported weekly billings from Excel file.
Office Manager
Sunshine Designs
Columbus, IN
05.2010 - 02.2013
- Produced and maintained thorough logs of project progress, conditions, and site attendance.
- Operated QuickBooks software that controlled payroll, accounts receivable, and accounts payable.
- Implemented new contacts and billing process to increase efficiency.
Administrative Assistant
CCI Roofing
Columbus, IN
05.2006 - 05.2010
- Operated QuickBooks software that controlled payroll, accounts receivable, and accounts payable.
- Implemented new estimating system, allowing Sales to turn estimates around quicker.
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
Education
Bachelor of Science - Business Management
Indiana University- Purdue University
Columbus, IN 08.2006 - 05.2012
High School Diploma -
Columbus North High School
Columbus, IN 08.2002 - 05.2006
Skills
Process improvement solutions
Planning and Organization
Process implementation
Budget forecasting
Financial analysis and reporting
Human resources knowledge
Relationship building and management
Account management
Insurance industry experience
Claims investigation and research
Policies and procedures
Strategic planning
Staff Management
Software
HSP Claims Processing Suite
Quickbooks Pro
Roof-CAD
Timeline
Director of Claims
SIHO Insurance Services
03.2020 - Current
Director of Claims Services
SIHO Insurance Services
03.2016 - 03.2020
Manager of Fully Insured Product
SIHO Insurance Services
03.2015 - 03.2016
Manager of Eligibility and COBRA
SIHO Insurance Services
03.2014 - 03.2015
Staff Accountant
SIHO Insurance Services
02.2013 - 03.2014
Office Manager
Sunshine Designs
05.2010 - 02.2013
Bachelor of Science - Business Management
Indiana University- Purdue University
08.2006 - 05.2012
Administrative Assistant
CCI Roofing
05.2006 - 05.2010
High School Diploma -
Columbus North High School
08.2002 - 05.2006