Kelly A. Larca
Healthcare
Prior Lake,MN.
Summary
Comprehensive experience in corporate level management specializing in office operations, including staff management and supportive supervision of staff, training, scheduling, payroll, human resources, accounts receivable/payable, bookkeeping, recognized as a results-oriented and solution-focused individual. Areas of strength include: EPIC training Human Resources/Benefits Knowledge of HMOs, Medicare HHM and Med soft billing systems Experienced Office Management and Administration Professional experienced optimizing productivity, efficiency and service quality across various environments. Highly dependable, ethical and reliable support specialist and leader that blends advanced organizational, technical and business acumen. Works effectively with cross-functional teams in ensuring operational and service excellence.
Overview
20
20
years of professional experience
Work History
Supervisor Call Center
Mystic Lake Casino Hotel
Prior Lake, MN
07.2016 - Current
- Insured implementation of call center policies, operations and performance standards were understood and followed by agents.
- Increased efficiency and productivity through effective staff training regarding customer service protocols and call resolution techniques.
- Reduced personnel turnover by developing and implementing performance evaluations to support corrective action planning.
- Improved organizational efficiency by effectively recruiting new hires and supporting management with personnel decisions.
- Trained team members on performance metrics and consumer behavior identification.
- Oversaw employee performance to foster accurate prioritization and achievement of sales and productivity goals.
- Monitored call quality and provided individual constructive feedback to enhance performance and address areas in need of improvement.
- Supervised 22 Call Center employees in providing excellent customer service to callers requiring assistance for hotel reservations and quality issues.
Team Captain, Clinic Review Pharmacy Technician
Aerotek- Prime Therapeutics
Edina, MN
12.2015 - 12.2016
- Responsible for, reviewing and documenting requests on both claims processing system and internal Request Tracking Database within predetermined timelines.
- Assisted communications between client and Prime Therapeutics regarding policies and procedures surrounding coverage of non-formulary medications and UM processes.
- (This communication includes client's customer service representatives, groups/plans, pharmacy, and physician offices).
- Entering approval records (e.g., prior authorization overrides) at drug-specific level to ensure appropriate claims will adjudicate.
- Selected as team captain to train 10 employees on newly implemented CMM software system based on experience, quick assimilation and understanding of system requirements.
Office Coordinator/ Trainer
Fairview Corporate
Saint Paul, Minnesota
12.2010 - 10.2015
- Assisted in training 75 employees on current business systems Epic, Oracle, My- Chart, Cisco phone systems and Experian health insurance website.
- Created benefits administration manual to provide departmental staff/ supervisors with current information and changes to benefits.
- Communicates with primary care, and other physicians for medical records, pre-op testing results, and pre-op medical clearance.
- Coordinated multiple office functions that focus on computerized scheduling, electronic billing, reimbursement, collections, accounts payable/receivable, patient records, data management and payment plans.
- 8 years' experience with insurance carriers, medical terminology, motor vehicle and workman's compensation pre-authorize/pre-certification, FMLA and CPT/ICD-9 codes.
- Advise employees on eligibility, provisions, coverage, and other matters related to benefits.
- Schedule appointments inpatient/outpatient surgical and clinical procedures for Sports Orthopedic, and OBGYN.
Front Desk Supervisor
Lifetime Fitness
Saint Louis Park, Minnesota
12.2008 - 11.2010
- Training and supervised all front desk employees, maintained monthly front desk staffing schedules for staff of 12 team members.
- Developed and maintained efficient relationships with vendors.
- Prepared all membership and fitness targets for club on monthly basis.
- Determined objectives and strategies to achieve revenue targets.
- Analyzed club activities and designed improvement strategies.
- Organized planning session for employee and evaluated performance.
Insurance Coordinator/ Financial Coordinator
Orthodontic Specialist
Lakeville, MN
11.2005 - 07.2008
- Review benefit eligibility affecting status changes such as department transfers, address changes, reduction in hours and employment termination.
- Interface between employees (flexible spending and COBRA administrator) and third party benefit providers.
- Ensured compliance to payer and regulatory guidelines for medical insurance claims processing and reimbursement.
- Referenced monthly aging reports to follow up on unpaid claims and obtain maximum reimbursement.
- Prepared insurance claims for submission to clearinghouses or insurance companies.
- Achieved revenue goals by managing collections and accounts receivables, referral process and insurance billing.
Education
Bachelor of Science - Human Resource Management
University of Phoenix
Tempe, AZ2013
Associate Degree - Business Management
Rasmussen College
Eagan, MN2008
Skills
- CDT/CPT Codes
- ICD-9, ICD-10
- Medical terminology
- Staff Management
- Employee Training
- Call Volume Analysis
- Customer Complaint Resolution
- New Hire Orientation
- Team Leadership
- Strategic planning and analysis
- Policy and procedure adherence
- Quality assurance
- Call Center Strategy
- Behavior Identification
- Benchmark Setting
Timeline
Supervisor Call Center
Mystic Lake Casino Hotel
07.2016 - Current
Team Captain, Clinic Review Pharmacy Technician
Aerotek- Prime Therapeutics
12.2015 - 12.2016
Office Coordinator/ Trainer
Fairview Corporate
12.2010 - 10.2015
Front Desk Supervisor
Lifetime Fitness
12.2008 - 11.2010
Insurance Coordinator/ Financial Coordinator
Orthodontic Specialist
11.2005 - 07.2008
Bachelor of Science - Human Resource Management
University of Phoenix
Associate Degree - Business Management
Rasmussen College
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