Cynthia Gardner

• Collaborated with teams to gather data and provide process improvement insights, creating enterprise dashboards with Data team that enhanced claims operations, resulting in $1.3 million in savings from quicker claims reviews.
• Supported compliance projects, partnering with Department of Insurance and internal teams across multiple regions to analyze claims for state and federal coding compliance, earning praise from state regulators for expertise and timely responses.
• Assisted in implementing standard operating procedures to streamline workflows and improve service delivery. Enhancements to the Enterprise reporting system allowed the team to recover over $12 Million Dollars on incorrectly processed claims.
• Spearheaded training programs for new and existing employees, ensuring adherence to company policies and standards while reviewing 100+ claims daily, leading to a 15% year-over-year reduction in leakage of incorrectly processed claims.
• Analyzed performance metrics to identify areas of improvement, driving process enhancements. $3.5 million dollars in savings were identified through these efforts - tying back to system or human errors.
• Collaborated with executive leadership to align operations goals with corporate strategy objectives. The team's main goal was to reduce incorrect post pay payments on claims. Gatekeeping post pay claims stopped $5.4 million dollars being paid in error before claim finalization.
• Built and maintained strong partnerships with key clients, resulting in expanded business opportunities and increased revenue. The team consistently resolved complex issues efficiently earning a strong reputation with both internal and external stakeholders.
• Championed new technology adoption to enhance operational capabilities and improve overall efficiency. Key player in the AI Pilot program dedicated to checking claim quality. This led to new processes that saved the company $2.7 million dollars in two years

• Developed and implemented strategic initiatives that significantly improved team performance and productivity. Leveraged employee feedback to streamline workflows and remove roadblocks, contributing to a 96% team retention rate.
• Mentored and coached junior staff, fostering career growth and promotional opportunities. Successfully guided: 4 Operations Experts into management roles; 6 associates into promotions within the company.
• Facilitated weekly team training sessions on best practices and procedure updates, enabling team to collaboratively address operational challenges, reducing customer abrasion and enhancing quality.
• Managed and motivated a team of 32-40 associates fostering productivity, engagement and high performance. Conducted monthly one-on-one meetings to provide timely feedback to proactively address concerns.
• Served as the pilot team to test real-time COVID claims and updated systems to comply with Federal regulations.
• Resolved internal conflicts through attentive listening and fair mediation, contributing to highest score on Employee Satisfaction Survey for managerial support and trust.
• Monitored daily operations and mentored staff, consistently achieving KPI targets in quality and productivity.
• Recruited, interviewed and onboarded new hires. Implemented daily and weekly feedback to ensure new hire retention rates remained above acceptable Enterprise standards.
• Oversaw inventory management through daily review. Worked closely with the Claim Inventory Department on work assignments and overall control of inventory levels.
• Conducted performance evaluations and provided constructive and fair feedback.

Large-Scale facilitation and knowledge transfer. Personally trained 1,000 + associates regarding enterprise post payment claims processing. This initiative led to a 30% reduction in post payment errors.

• Designed instructional materials utilizing current industry standards and adult learning principles for- end-to-end Claims Processing. Trained this curriculum overseas (Philippines and India). Had the highest retention rate of students enterprise wide and received the Award of Excellence.
• Initiated daily post-training check-ins for four weeks after class completions to ensure comprehension, retention, and timely clarification of key concepts, resulting in 99% of associates passing knowledge checks.
• Measured training effectiveness through structured feedback, surveys, and performance metrics; leveraged data to create real-time statistics that increased quality percentages year over year.
• Mentored individuals in subject matter, achieving high accuracy rates for training teams.