Melissa Young
Business Professional
Chapin,SC
Summary
Results-driven Financial Claims Operations Manager with 21 years of experience in driving operational excellence, leading virtual teams, and managing international relationships. Solid history balancing team performance, client service targets, and business objectives, while delivering high-quality claims results. Exceptional communication and leadership skills to foster collaboration and drive cross-functional initiatives.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Manager II Financial Ops
Elevance Health (Formerly Anthem, Inc.)
Middletown, NY
07.2019 - 11.2023
- Successfully led the implementation of a new enterprise prevention coordination of benefits team which included creating and implementing 5 comprehensive training plans for 4 different processing platforms, ensuring adherence to quality standards for 28 new hires.
- Spearheaded collaboration with peer Managers, utilizing technical skills in data analysis and system management to perform comprehensive review of production reporting system and ascertain missing data essential for all prevention associates. Implemented necessary parameters in the system, resulting in 100% completion rate.
- Assumed responsibility for additional coordination of benefits processing team with multiple processing platforms, enhancing the efficiency and effectiveness of the team's operations. Reviewed and implemented fair platform schedule, allowing all specialists to focus on end state migration platform, ensuring future success and alignment to the business needs.
- Founding member in newly established Manager Dashboard workgroup, which developed and refined the dashboard, integrating vital metrics such as staffing, budget, inventory trends, and project status, resulting in enhanced visibility and decision-making capabilities for Managers.
- Attended daily/weekly/monthly collaboration with project stakeholders to analyze staffing needs, assess training requirements, and develop approaches for issue resolution for the CS90 Kernel platform implementation.
- Successfully managed and supported teams in a virtual environment, ensuring appropriate staffing levels, compliance with written protocols, and adherence to production and quality metrics.
Manager Claims Audit
Anthem, Inc.
Middletown, NY
06.2014 - 07.2019
- Managed and supervised Enterprise High Dollar team, tracking performance measures and metrics to ensure team members consistently achieved or surpassed targets amidst migration to new processing platform.
- Successfully led the integration of two regional high dollar review teams into one standardized team, resulting in improved efficiency and productivity.
- Improved customer outcomes by promoting a decrease in High Dollar returns through strategic data analysis and training initiatives.
- Collaborated with Account Management team and client contacts to successfully resolve issues, resulting in an increase in client satisfaction.
- Collaborated with finance team to discuss staffing models, ensuring accurate parameter input and optimal staffing levels during implementation of new inventory management software.
- Conferred with HR to conduct comprehensive compensation reviews, ensuring equitable titles and competitive pay for high-value organization.
Manager II Claims
Anthem, Inc. (Formerly WellPoint)
Middletown, NY
05.2009 - 06.2014
- Managed and supervised Adjustments, Correspondence, Vendor Return Claims, Supplemental High Dollar, and High Dollar teams on multiple processing platforms for NY National business, tracking performance measures and metrics to ensure team members consistently achieved or surpassed targets.
- Demonstrated proficiency in staff management and project coordination, ensuring seamless execution of deliverables.
- Successfully managed a confidential sourcing project for a global organization, traveling to India and the Philippines in 2012 to ensure a smooth transition of duties and facilitate effective communication between teams.
- Collaborated with the Internal Audit team during the audit of High Dollar in 2014/2015 to investigate and rectify identified issues, enhancing efficiency and minimizing financial risks.
- Managed the successful migration of National accounts from CS90 to Nasco, upskilling the entire team and transitioning to the Nasco platform.
Education
High School Diploma -
Minisink Valley High School
Slate Hill, NYSkills
- Operations and Cross-Functional Team Management
- Employee Hiring, Onboarding, and Development
- Performance Management, Evaluation, and Monitoring
- Inventory Tracking and Management
- Business Planning and Growth Initiatives
- Data Analysis
- Quality Assurance
- Change Management
- Leadership: Communication, Active Listening, Partnerships, Teamwork, International Relationships
- Technical: Microsoft Office, Microsoft Teams, Adobe
Certification
- Lean Six Sigma White Belt, Elevance Health, 2023
- Lean Six Sigma Yellow Belt, Elevance Health, 2023
Projects
Sourcing Ops Project | Elevance Health | September 2011 - December 2012
- Supported a highly confidential sourcing project in 2011 resulting in travel to India and the Philippines to personally oversee the transition, ensuring smooth operations and adherence to project timelines. Maintained regular communication with offshore Accenture partners, ensuring seamless collaboration and timely project updates. Implemented a new vendor claims return team to streamline operations and support work processes for both internal stakeholders and external Accenture partners.
Affiliations
Community Volunteer | Irmo Little League | February 2023 - Present
- Concession Stand Officer, in charge of managing inventory within a set budget and ensuring appropriate volunteer staffing to keep concession stand open and running for all games and tournaments.
- Team Parent, ensuring coaches have all needed support and parents are up to date on all requirements in order to have a successful season.
Board of Education Member | Minisink Valley Central School District Board of Education | July 2021 - July 2022
- Elected by the district community to serve a 3 year volunteer term on the board of education. Relocation out of state reduced the term length.
PTO Volunteer | Minisink Valley Elementary School PTO | September 2019 - June 2022
- Collaborated with board members to plan and execute successful events, resulting in increased community engagement and attendance.
- Assisted in efficiently organizing and packing field day swag for both students and teachers.
- Photographed various events and captured high-quality images for use in yearbook.
Community Volunteer | Minisink Valley Youth Football League | August 2019 - November 2021
- Facilitated effective communication with parents, providing timely updates on team requirements and fostering a cohesive and informed parent community.
- Managed concession stand during games and tournaments to ensure uninterrupted operations.
Timeline
Manager II Financial Ops
Elevance Health (Formerly Anthem, Inc.)
07.2019 - 11.2023
Manager Claims Audit
Anthem, Inc.
06.2014 - 07.2019
Manager II Claims
Anthem, Inc. (Formerly WellPoint)
05.2009 - 06.2014
High School Diploma -
Minisink Valley High School
- Lean Six Sigma White Belt, Elevance Health, 2023
- Lean Six Sigma Yellow Belt, Elevance Health, 2023
Similar Profiles
SHERI LUNDSHERI LUND
Medical Underwriter Senior (Work at Home) at Elevance Health (formerly Anthem Inc.)Medical Underwriter Senior (Work at Home) at Elevance Health (formerly Anthem Inc.)
GLENDORA SPRINGERGLENDORA SPRINGER
Senior Systems Analyst at Elevance Health (formerly Anthem Inc)Senior Systems Analyst at Elevance Health (formerly Anthem Inc)
Meridith WoodmanMeridith Woodman
Director Pharmacy Client Experience (CE) Program & Project Mgmt – Carelon Rx Sales Acct Mgmt at Elevance Health (formerly Anthem, Inc.)Director Pharmacy Client Experience (CE) Program & Project Mgmt – Carelon Rx Sales Acct Mgmt at Elevance Health (formerly Anthem, Inc.)