Summary
Overview
Work History
Education
Skills
Timeline
RegisteredNurse

Grace McMullen

SPRINGFIELD,PA

Summary

Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.

Overview

16
16
years of professional experience

Work History

Director of Insurance

Continuous Home Care
2016.01 - Current
  • Built relationships with clients using active listening and issue resolution to provide excellent service.
  • Responded to customer calls swiftly to resolve issues and answer questions.
  • Maintained high standards of customer service by building relationships with clients.
  • Cross-sold insurance products to existing clients to reach sales targets.
  • Prepared and reviewed insurance applications to verify compliance with regulations.
  • Monitored changes in insurance industry to stay compliant with relevant laws and regulations.
  • Investigated and processed claims swiftly to keep customers satisfied.
  • Identified potential risks in client businesses and recommended appropriate insurance coverage.
  • Educated clients on insurance policies and procedures.
  • Investigated and processed claims swiftly to keep customers satisfied.
  • Managed team of five in insurance authorizations and appeals.

Operations Manager

Continuous Home Care
2014.11 - 2016.01
  • Supervised operations staff and kept employees compliant with company policies and procedures.
  • Developed systems and procedures to improve operational quality and team efficiency.
  • Established positive and effective communication among unit staff and organization leadership, reducing miscommunications, and missed deadlines.
  • Managed over 12 HMO and PPO insurance contracts
  • Developed systems and procedures to improve operational quality and team efficiency.
  • Developed and implemented strategies to maximize customer satisfaction.
  • Directed initiatives to improve work environment, company culture or overall business strategy.
  • Introduced new methods, practices, and systems to reduce turnaround time.
  • Implemented process improvement to shape organizational culture, optimize procedures for higher efficiency and help company evolve and grow.
  • Analyzed and reported on key performance metrics to senior management.
  • Devised processes to boost long-term business success and increase profit levels.
  • Trained new employees on proper protocols and customer service standards.
  • Interacted well with customers to build connections and nurture relationships.
  • Trained and guided team members to maintain high productivity and performance metrics.
  • Assisted in recruiting, hiring and training of team members.
  • Reported issues to higher management with great detail.
  • Cultivated and strengthened lasting client relationships using strong issue resolution and dynamic communication skills.

Director of Client Intake

Continuous Home Care
2012.04 - 2014.11
  • Moved seamlessly from strategic, innovative and big picture perspective to finest details and delivered operational success.
  • Headed off issues and proactively implemented plans and actions to mitigate.
  • Managed relationships with executive sponsors and key client team members at required levels in organization.
  • Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions.
  • Maintained professional demeanor by staying calm when addressing unhappy or angry customers.
  • Evaluated employee performance and conveyed constructive feedback to improve skills.
  • Assisted in organizing and overseeing assignments to drive operational excellence.
  • Used industry expertise, customer service skills and analytical nature to resolve customer concerns and promote loyalty.
  • Cultivated positive rapport with fellow employees to boost company morale and promote employee retention.
  • Trained personnel in equipment maintenance and enforced participation in exercises focused on developing key skills.
  • Improved staffing during busy periods by creating employee schedules and monitoring call-outs.
  • Managed over 50 customer calls per day

Patient Care Coordinator

Continuous Home Care
2010.10 - 2012.04
  • Maintained confidentiality of patient data and condition to safeguard health information.
  • Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.
  • Acted as main point of contact for patients, doctors, and hospital staff by closely reviewing medical charts and maintaining high levels of communication.
  • Worked closely with patients to deliver excellent and direct individualized patient care.
  • Delivered excellent patient experiences and direct care.
  • Upheld confidentiality requirements and regulatory compliance guidelines.
  • Monitored patient health records for accuracy to meet compliance with healthcare guidelines.
  • Provided support and guidance to patients and families to navigate healthcare systems.
  • Assisted patients with coordinating long-term care for chronic conditions to support and manage illnesses.
  • Performed as subject matter expert for case management processes.
  • Answered incoming calls, scheduled appointments and filed medical records.

Residence Life Coordinator

Neumann University
2009.06 - 2011.01
  • Assisted residents with transitioning into new living environment and maintained strong relationships with residents.
  • Enforced policies and safety standards through building and room rounds.
  • Coordinated activities and events to create safe, positive and inclusive environment.
  • Provided crisis management and intervention during emergency situations.

Processing Associate

Vanguard
2007.11 - 2009.05
  • Collaborated with team to define business requirements for organizational processes, achieve productivity standards, and adhere to accuracy standards.
  • Identified and resolved process issues to drive optimal workflow and business growth.
  • Developed standard operating procedures and document workflows to drive current and future processes.
  • Determined and recommended methods to implement improvement opportunities.
  • Adhered to established policies, procedures and compliance for satisfactory audit rating.

Education

Bachelor of Science - Human Development And Family Studies

Pennsylvania State University
Media
06.2007

Skills

  • Oral and Writing Communication
  • Financial Needs Assessment
  • Client Account Management
  • Medicare Compliance

Timeline

Director of Insurance

Continuous Home Care
2016.01 - Current

Operations Manager

Continuous Home Care
2014.11 - 2016.01

Director of Client Intake

Continuous Home Care
2012.04 - 2014.11

Patient Care Coordinator

Continuous Home Care
2010.10 - 2012.04

Residence Life Coordinator

Neumann University
2009.06 - 2011.01

Processing Associate

Vanguard
2007.11 - 2009.05

Bachelor of Science - Human Development And Family Studies

Pennsylvania State University
Grace McMullen