Amanda Rose Smith
Ringgold,GA
Summary
Results-oriented business leader with more than 14 years experience in day-to-day business operations management in addition to project guidance and oversight Effective collaborator to key clients, accounts and external business stakeholders. Leverage trends across industries and markets to derive solutions and approaches focused on creating value for customers and profitability for company. Streamlines existing processes for efficiency and productivity. Well-versed in applying multi-faceted approach to managing leaders, operations, and productivity across multiple business lines. Process improvement specialist adept in creating seamless integration of new operations, processes, and business solutions.
Overview
22
22
years of professional experience
Work History
Customer Service Senior Manager
Cigna Healthcare
Chattanooga, TN
04.2022 - Current
- Led cross-functional teams to enhance operational efficiency and improve service delivery.
- Developed and implemented strategic initiatives that aligned with organizational goals and improved patient outcomes.
- Mentored junior managers, fostering professional growth and enhancing team performance.
- Analyzed market trends to identify opportunities for product innovation and service improvement.
- Collaborated with stakeholders to design effective healthcare programs tailored to diverse populations.
- Streamlined processes resulting in reduced turnaround times for client services and increased customer satisfaction.
- Oversaw budget management, ensuring optimal allocation of resources to support departmental objectives.
- Established key performance indicators to monitor progress and drive continuous improvement initiatives.
- Reduced costs, optimized resource allocation, and improved efficiency in managing projects.
- Managed large-scale projects and introduced new systems, tools, and processes to achieve challenging objectives.
- Implemented innovative solutions to overcome challenges, leading to enhanced productivity levels.
- Executed appropriate staffing and budgetary plans to align with business forecasts.
- Championed process improvement initiatives that led to significant cost savings without compromising on quality standards.
- Spearheaded change management efforts for seamless adoption of new systems or processes among employees.
- Drove adoption of new technology solutions, modernizing operations and improving operational efficiency.
- Negotiated high-value contracts with new suppliers, securing better pricing and terms, which improved profit margins.
Customer Service Manager
Cigna Healthcare
Chattanooga, TN
04.2018 - 04.2022
- Operations management of 7+ unique teams focused on customer service escalations and service recovery opportunities. These teams included customer facing roles, claims and appeals roles, customer outreach, and clinical and social services teams.
- Reviewed customer escalation trends, service opportunities, and internal processes and suggested strategies for streamlining operations.
- Maximized productivity and management systems by establishing specific goals and managing operations.
- Established operational objectives and work plans and delegated assignments to subordinate managers.
- Fostered an environment which encouraged continual process improvements and innovation.
- Identified and targeted areas in need of improvement through close monitoring and tracking of daily operations.
- Minimized regulatory risks by carefully following legal regulations to deliver complete compliance.
- Assisted in data migration to new data repositories, ensuring a seamless transition and minimal business disruption. Worked with vendors to create a customized system view for improved tracking and logging of customer surveys for the organization.
- Worked collaboratively with internal and external stakeholders across Service , Client , Marketing and Sales Operations.
- Monitored customer feedback to devise business strategies and determine process improvements for better customer experiences.
- Developed and implemented a step-down customer support model geared toward stabilizing high need customers, transitioning them to lower cost support level models quickly and without impacting the customer experience.
- Engaged with marketing department to launch promotional activities and awareness campaigns for World Crisis Events model, which lends proactive outreach support to customers impacted by tragic world events and loss of loved ones.
Customer Service Specialist
Cigna HealthCare
Chattanooga, TN
01.2016 - 06.2018
- Leading a team who investigates and resolves customer inquiries and complaints in a timely and empathetic manner.
- Ensure the delivery of reports/metrics, comparing actuals vs. anticipated trending, and driving process improvements to provide continual improvement.
- Supplied business process improvements and updating process documentation to align with improvement.
- Coordinating with internal and external partners around customer experience issues and providing action plans to correct.
- Partner with other business areas and Infrastructure Operations.
- Subject matter expert for benefit coverage mistakes.
- Compliance & Risk Issues Sub-Committee contributor.
- Business experience in project management, being the bridge between administration and development teams.
- Capacity and inventory management.
Appeals Specialist
Cigna HealthCare
Chattanooga, TN
12.2014 - 01.2016
- Managed team of 17-25 appeals associates.
- Utilized MOS tools along with active management to positively reinforce employee engagement to achieve KPI - Key Performance Measurement Goals.
- Liaison for dedicated accounts. Tasked with ensuring the account's performance guarantee with the National Appeals Organization had met the contractual obligation according to the plans and specifications.
- Collaborated with key matrix partners to ensure processes were followed and expectations met.
- Key business partner for Service Operations project to review benefit coverage mistakes.
Claims Supervisor
Cigna HealthCare
Chattanooga, TN
06.2013 - 12.2014
- Managed team of 17-25 Shared Administration claim processors.
- Liaison for Cigna Medical and Cigna Global Health Benefits on the Shared Administration book of business for customer and client issues.
- Established efficient processes with the electronic mail room for Cigna Global Health Benefits paper claims fall out issues.
- Monitored individual, team to identify and act on both positive and negative trends to ensure attainment of financial quality results and performance targets.
- Utilized MOS tools along with active management to positively reinforce employee engagement to achieve KPI - Key Performance Measurement goals.
- Focused on achieving key performance results and improving the overall customer experience by identifying process improvement opportunities and driving a culture of customer centricity.
Claims Service Analyst
Cigna HealthCare
Chattanooga, TN
10.2007 - 06.2013
- Shared Administration (PPN SAR) claims processing.
- Participated in process improvement projects, conducting pilot groups and rolling out full processes.
- Supported quality coach area answering questions and up training on specific topics.
- Cross trained associates on behavioral health claim processing and other business needs.
- Joined Manager in Training program (MIT) . Actively managed a team of 17-20 claims processors.
- Early adopter of management operating system (MOS) for supervisors.
- Participated in system release projects,testing resource for claim related projects and initiatives.
Customer Service Manager
Blockbuster Video Franchise
Fort Oglethorpe, GA
01.2005 - 10.2007
- Solved unresolved customer issues.
- Assumed ownership over team productivity and managed work flow to meet or exceed quality service goals.
- Strong leader of customer support staff.
- Scheduled staff shifts to cover peaks and lulls in customer inquiries.
- Trained staff on operating procedures and company services.
- Identified individual development needs with appropriate training.
- Maintained accurate records of past due customer account activity.
- Maintained up-to-date knowledge of product and service changes.
- Quantified sales and membership quotas.
Education
Bachelor of Science - Health Sciences
Southern New Hampshire University
Hooksett, NH12-2025
Associate of Science - Medical Assisting- Associate of Applied Science
Georgia Northwestern Technical College-Walker County Campus
Rock Spring, GA2004
Skills
- Operations management
- Leadership development
- Process improvement specialist
- Ability to work and deliver under pressure
- Excellent 0rganizational agility
- Exceptional interpersonal communication
- Enthusiastic problem solver
- Strong technical skills
- Efficient decision maker
- Risk analysis and management
- Project development and life cycle
- Policies and Procedures Implementation
Timeline
Customer Service Senior Manager
Cigna Healthcare
04.2022 - Current
Customer Service Manager
Cigna Healthcare
04.2018 - 04.2022
Customer Service Specialist
Cigna HealthCare
01.2016 - 06.2018
Appeals Specialist
Cigna HealthCare
12.2014 - 01.2016
Claims Supervisor
Cigna HealthCare
06.2013 - 12.2014
Claims Service Analyst
Cigna HealthCare
10.2007 - 06.2013
Customer Service Manager
Blockbuster Video Franchise
01.2005 - 10.2007
Associate of Science - Medical Assisting- Associate of Applied Science
Georgia Northwestern Technical College-Walker County Campus
Bachelor of Science - Health Sciences
Southern New Hampshire University