Liezel Putman
Princeville,USA
Summary
Experienced professional with customer service, analytical and project management skills, with over 20 years background in healthcare administration, Medicare and commercial compliance and member complaint resolution.
Overview
15
15
years of professional experience
Work History
Senior Business Analyst/Consultant
Kaiser Permanente
San Diego, CA
01.2019 - 01.2021
- Initiates, assists and supports process improvements for Medicare operations based on the research conducted and the data collected from CTM complaints
- Supports management requests to analyze and research projects such as root cause analysis, time studies, testing for effectiveness and efficiency when processing
- Assists and supports peers for direction on case investigation
- Identifies and reports trends to management of root causes that can reduce CTM complaints
- Expertly researches and accurately responds to complaints filed by members through 1-800-Medicare within a timeframe mandated by CMS
- Maintains up to date knowledge on CMS regulations, as well as, Medicare operations policies and procedures to support the research conducted
Business Analyst/Consultant
Kaiser Permanente
San Diego, CA
01.2014 - 01.2019
- Initiates, assists and supports process improvements for Medicare operations based on the research conducted and the data collected from CTM complaints
- Supports management requests to analyze and research projects such as root cause analysis, time studies, testing for effectiveness and efficiency when processing
- Assists and supports peers for direction on case investigation
- Identifies and reports trends to management of root causes that can reduce CTM complaints
- Expertly researches and accurately responds to complaints filed by members through 1-800-Medicare within a timeframe mandated by CMS
- Maintains up to date knowledge on CMS regulations, as well as, Medicare operations policies and procedures to support the research conducted
Account Administration Representative
Kaiser Permanente
San Diego, CA
01.2011 - 01.2014
- Performed Medicare member maintenance through the MOSS NGT database, FS, TMS, CM, Sharepoint and MP
- Supported management requests to analyze and research projects such as clean up reports, complex NGT issues and time studies for effectiveness and efficiency when processing
- Provided recommendations to improve business processes
- Accountable for notifying members in the NGT process by providing the appropriate correspondence and making outbound calls while remaining compliant with CMS
- Assigned to process enrollments, PBP changes, disenrollments and cancellations
Account Administration Representative
Kaiser Permanente
San Diego, CA
01.2009 - 01.2011
- Processed manual and electronic enrollment and disenrollments for Medi-Cal, Healthy Families, State and Inter-regional groups
- Performed manual and electronic membership maintenance, billing and reconciliation reporting for multi-million high profile Medi-Cal and State groups
- Supported account managers and brokers requests and ensured their needs were met
- Responsible for allocation of multi-million dollar payments received from the Medi-Cal and State groups
Case Manager
Kaiser Permanente
San Diego, CA
01.2006 - 01.2007
- Accountable for investigating and resolving commercial complaints and grievances that were submitted to the Member Correspondence Resolution Center by KP members
- Ensured that complaints and grievances were processed in accordance with policies and procedures, compliance standards and regulations
- Collaborated with internal staff such as other Member Services departments, managers and physicians to resolve cases accurately and quickly as possible
Education
Bachelor of Science - Hotel and Restaurant Management
St Paul University Manila
Manila, Philippines01.1998
High School Diploma -
The Peninsula School
Bataan, Philippines01.1995
Skills
- Excellent customer service in Member Services and the California Service Center
- Working knowledge of relevant computer systems: EPIC, MP, FS, TMS, CM, MOSS, CARS, PSP, Microsoft Word, Excel and PowerPoint
- Strong organizational skills and ability to prioritize and work on multiple tasks in a time sensitive environment
- Strong professional relationships within the organization
- Excellent written and verbal communication skills
Accomplishments
- Assisted, tested and supported CTM MOSS enhancements that have increased efficiency and accuracy
- Assisted in the SSA letter verbiage update project that included drafting, approval and implementation of new SSA letters
- Created MS Excel CTM tool that facilitates convenient access to documents, references, websites, etc.
- Initiated SSA deduction verbiage change for KPSA election forms
- Updated good cause reinstatement training documentation and download procedure
- Conducted research and collaboration with CTM business analysts, management and other departments
- Assisted in the Prior Call initiative CSC Phone team project that helped improve MSCC and the Medicare team's business processes
- Completed time study on CTM team processes, resulting in successful approval of 4 additional full time employees
References
References provided upon request
Timeline
Senior Business Analyst/Consultant
Kaiser Permanente
01.2019 - 01.2021
Business Analyst/Consultant
Kaiser Permanente
01.2014 - 01.2019
Account Administration Representative
Kaiser Permanente
01.2011 - 01.2014
Account Administration Representative
Kaiser Permanente
01.2009 - 01.2011
Case Manager
Kaiser Permanente
01.2006 - 01.2007
Bachelor of Science - Hotel and Restaurant Management
St Paul University Manila
High School Diploma -
The Peninsula School
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