Karen Ward

• Coached new team members on service techniques and provided scoring through quality assurance program.
• Led regular team training hours to review performance data, discuss best practices, and collaborate on continuous improvement initiatives.
• Ensure compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
• Collaborated with team members to identify areas for improvement in customer service processes, implementing changes as needed.
• Promoted a positive work environment through active participation in team meetings and contributing ideas for organizational success.
• Work on maintaining Job aide updates when needed for updated workflows
• Work on schedules for 2 teams.
• Review error trackers and monthly internal audits and use them for training purposes.
• Have worked across lines to help other areas with issues for both provider and members.
• Helped build the Commercial PreD template in the QuickBase.
• Work with CMAs on a daily basis helping answer questions and concerns.
• Implemented a CMA recharge meeting for a place for CMAs to take a break and get to know each other.
• I lead the CMA Culture advocates as the CMA Culture Champion.

Started out working in the disease management program recruiting members to speak to a nurse to be able to manage their health for any thing needed such as Diabetes, High blood pressure or High cholesterol.

Moved to the Clinical Claims Review Dept working on Live claim reviews, therapy reviews and Predeterminations.

Moved to the preservice department in March of 2018 working Commercial Predeterminations and added Medicare PreD's along with Medicare and Commercial Precert reviews.