Kasey Angevine
Warwick,RI
Summary
Accomplished Healthcare & Insurance Operations Team Lead with 8 years of experience in managing and optimizing operational processes within the healthcare and insurance industry. Skilled in supervising cross-functional teams, implementing process improvements, and ensuring compliance with industry regulations. Adept at fostering strong relationships with key stakeholders to drive organizational success. Proven ability to streamline operations, enhance productivity, and deliver exceptional customer service. Looking to leverage expertise in leading high-performing teams to drive operational excellence within a progressive healthcare or insurance organization.
Overview
21
21
years of professional experience
Work History
HC & Insurance Operations Senior Team Lead
NTT Data/HCL Tech
12.2016 - Current
- Manage and assign inventory ensuring claims are processed timely in accordance with the client's Service Level Agreements.
- Serve as the primary point of contact for escalated claims issues and worked closely with the client to resolve any issues.
- Monitor quality and productivity for new and existing team members and provide coaching when applicable.
- Assist in developing and preparing SOP's for new processes.
- Identify process improvement opportunities to enhance operational effectiveness.
- Provide training and support to staff on industry regulations, best practices, and system functionalities to optimize workflow and performance.
- Conduct in-depth research of claims processing issues and system-related problems. Report and track any incidents or defects.
- Compile and analyze data to identify trends for Root Cause Analysis.
- Perform testing for system implementations and upgrades.
- Handle incoming Plan 2 Plan calls regarding complex and escalated claim issues.
- Process and adjust complex claims, ensuring accuracy and adherence to company policies.
HC & Insurance Operations Analyst
Dell Services
11.2009 - 12.2016
- Processed and adjusted complex claims, ensuring accuracy and adherence to company policies.
- Provided timely and accurate responses to inquiries from members, providers, and other Blues Plans demonstrating strong communication and customer service skills.
- Handled incoming Plan 2 Plan calls regarding complex and escalated claim issues.
- Served as a mentor and Subject Matter Expert in all claims entry, workflow and inquiry processes.
- Performed testing for system implementations and upgrades.
- Verified the accuracy of submitted data on incoming claims.
- Research member's policy and benefit limits.
- Corrected errors and cleared system pends to allow for claim processing.
- Exceeded company productivity and quality standards.
HC & Insurance Operations Claims Processor
Perot Systems
05.2005 - 11.2009
- Verified the accuracy of submitted data on incoming claims.
- Research member's policy and benefit limits.
- Corrected errors and cleared system pends to allow for claim processing.
- Exceeded company productivity and quality standards.
Education
High School Deploma -
William E. Tolman High School
Pawtucket, RI06-2000
Skills
- Inventory Management
- Staff Training and Development
- Team Leadership
- Business Process Outsourcing
- Continuous Improvement
- Root Cause Analysis
- Health Insurance Industry Knowledge
- Claims Processing
- Medical Billing and Coding
- Data Entry
- Medical Records
- Customer Service
Software
Facets
Salesforce
RSD Folders Imaging System
Macess Imaging System
BlueWeb Portal
Microsoft Office
Five9
Timeline
HC & Insurance Operations Senior Team Lead
NTT Data/HCL Tech
12.2016 - Current
HC & Insurance Operations Analyst
Dell Services
11.2009 - 12.2016
HC & Insurance Operations Claims Processor
Perot Systems
05.2005 - 11.2009
High School Deploma -
William E. Tolman High School