Summary
Overview
Work History
Education
Skills
Timeline
Generic

Ryan Sandoval

Geneva,IL

Summary


Experienced with managing client programs and driving project success. Utilizes strong communication and leadership skills to align team efforts with client objectives. Track record of delivering high-quality results and maintaining productive client relationships.

Overview

16
16
years of professional experience

Work History

Client Program Manager

MITCHELL INTERNATIONAL
03.2020 - Current
  • Drives client satisfaction, communication, and contributes to the overall management of the client relationship
  • Manage inventory – thousands of medical bills, both workman's compensation and auto accident claims
  • Maintain compliance with TAT guidelines differing with different jurisdictions to avoid fines/penalties
  • Manage offshore auditing teams
  • Hold daily meetings to go over any issues, present projects, offer daily processing solutions and quality assurance
  • Complete / Present daily, weekly, and monthly inventory reports to client
  • Handle client-initiated escalations, investigating issues and providing quick solutions
  • Increased client satisfaction by effectively managing multiple program portfolios and ensuring timely delivery of projects
  • Improved project efficiency by streamlining communication channels between various stakeholders, including clients, vendors, and internal teams
  • Conducted regular performance reviews with team members to ensure continuous improvement in service quality and client satisfaction

Medical Cost Reviewer

GENEX SERVICES
12.2016 - 03.2020
  • Analyze and review workman's compensation claims to reduce cost to insurance companies providing the coverage to the injured employee
  • Use software to determine state fee schedules and apply PPO Networks to reduce total amount owed on each claim to medical providers
  • Work closely with adjusters to accommodate special requests
  • Had to be approved by two clients, based on experience/work record, to review their bills/handle requests
  • Handling of appeals from medical providers requesting additional payment
  • Conducting research to determine if additional funds are appropriate

EDI Team Supervisor

GENEX SERVICES
02.2014 - 11.2016
  • Responsible for a team of25 employees working data entry positions
  • Led quality assurance meetings with groups as well as individuals
  • Maintained great ongoing client relationships by meeting their standards
  • Organized work models to achieve maximum productivity
  • Enhanced team productivity by implementing efficient workflow processes and monitoring daily progress
  • Developed a cohesive team environment through regular communication, collaboration, and constructive feedback

Negotiation Specialist

GENEX SERVICES
05.2009 - 01.2014
  • Analyze workman's compensation claims for insurance clients to negotiate a fair and equitable outcome for both medical provider and client
  • Tracked record of major accomplishments delivering results of increased revenue and cost savings
  • Regularly achieved savings of $10,000 or more per bill by researching state legislation, reviewing medical provider cost reports, and crating assertive proposals to achieve desired outcome

Education

Bachelor of Arts - Philosophy

Northern Illinois University
DeKalb, IL

Skills

  • Salesforce
  • SmartAdvisor
  • Account Management
  • Client Relationship Building
  • Time Management
  • Multitasking
  • Project Implementation
  • Resource Allocation
  • Quality Assurance

Timeline

Client Program Manager

MITCHELL INTERNATIONAL
03.2020 - Current

Medical Cost Reviewer

GENEX SERVICES
12.2016 - 03.2020

EDI Team Supervisor

GENEX SERVICES
02.2014 - 11.2016

Negotiation Specialist

GENEX SERVICES
05.2009 - 01.2014

Bachelor of Arts - Philosophy

Northern Illinois University
Ryan Sandoval