MICHELE LOCKETT
Minneapolis,MN
Summary
Learning and development professional with proven track record in creating impactful training programs that boost organizational effectiveness. Known for fostering collaborative environment and delivering results in dynamic settings. Proficient in needs assessment, curriculum development, and facilitation, with reputation for reliability and adaptability. Recognized with multiple awards, including CEO Roundtable Awards and Hats Off To U Awards.
Overview
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Certification
Work History
Learning & Development Specialist Senior
UCare
01.2020 - 2025
- Develop, maintain, implement, and audit corporate core training materials.
- Develop and implement tools for reporting effectiveness of training sessions/classes.
- Identify knowledge gaps and opportunities for new and existing staff.
- Train new and tenured staff on new claim processing processes.
- In collaboration with other stakeholders and committees, participate in user groups testing and delivery of training programs for UCare staff.
- Formulate and revise desktop protocols, spanning various operational domains, incorporating the crosswalk transition from Amisys to HealthRules, software during the execution and evaluation of different test scenarios.
- Creating foundational training stages and timetables in accordance with required skill levels.
- Assessed corporate strategies and suggested growth measures for stakeholders to achieve institutional objectives.
- Evaluate user responses regarding the efficiency of the course content and pinpoint potential areas for enhancement.
- Improved training program attendance by 40% by implementing interactive learning modules.
- Cut onboarding process duration by 30% by optimizing training materials and schedules.
- Oversaw training programs for 500+ employees across 5 different departments.
- Secured a company-wide training satisfaction score increase to 90% by redesigning the curriculum.
- Achieved a 95% pass rate on post-training assessments by developing targeted training modules.
- Increased employee satisfaction scores by 20% by revamping the onboarding process.
- Coordinated training programs for 150+ employees across the organization.
- Achieved a 95% pass rate on post-training evaluations by designing and implementing a customized L&D curriculum.
- Developed and implemented training programs enhancing employee skills and knowledge retention.
- Collaborated with cross-functional teams to identify learning needs and design tailored solutions.
- Evaluated training effectiveness through feedback surveys, adapting content for continuous improvement.
- Streamlined onboarding processes, enhancing new hire orientation to improve integration experience.
- Evaluated training program effectiveness, adjusting content as needed to maximize learning outcomes.
- Increased employee retention rates by developing engaging onboarding and orientation processes.
- Spearheaded the creation of a mentorship program, matching experienced employees with newer hires for accelerated skills transfer.
- Aligned training programs with organizational goals, ensuring that learning initiatives directly supported overarching business objectives.
- Led development of learning management system to streamline training processes and content accessibility.
Claims Supervisor
UCare
2017 - 2020
- Achieved successful recruitment and selection of new staff, enhancing team capabilities. Improved employee performance through effective training and coaching, streamlining daily schedules and workflow. Provided constructive performance feedback, fostering a culture of continuous improvement.
- Collaborated in establishing department objectives and performance indicators to proactively address emerging issues and trends.
- Collaborated with management to design and finalize comprehensive monthly reports detailing departmental activities, challenges, and achievements.
- Led cross-functional teams in the implementation of innovative processes, software, and products. Oversaw testing, training, and system upgrades to enhance product and procedural efficiency.
- Acted as primary liaison for UCare claims employees, ensuring accurate policy information and effective resolution of intricate claim challenges.
- Led monthly team meetings with staff and stakeholders to foster collaboration. Assisted manager in executing department meetings by developing agendas, presenting information, and ensuring timely distribution of meeting minutes.
- Achieved effective resolution of claims issues through the development and review of comprehensive work instructions. Enhanced stakeholder awareness by communicating changes in a timely manner.
- Attend internal or external department and other focus group meetings.
- Maintain positive and professional working relationships with staff and other stakeholders to ensure departmental or cross-departmental issues are resolved in a timely manner.
- Assisted in analyzing processed claims data and adjustment reason codes to identify payment and denial trends. Supported adjustment projects by reviewing recovery data and related documentation. Aided in implementing changes to claims work instructions and system configurations.
- Reduced processing times by 30% for high-priority claims, resulting in improved customer satisfaction rates.
- Streamlined claims resolution process, achieving a 95% success rate by optimizing team workflows and enhancing training programs.
- Oversaw claims processing operations, ensuring compliance with regulatory standards and company policies.
- Mentored team members in best practices for claims adjudication and customer service excellence.
- Coordinated cross-departmental collaboration to resolve complex claims issues, improving overall resolution rates.
- Developed training programs for new hires, enhancing team performance and knowledge retention.
- Evaluated staff performance, providing constructive feedback to promote professional development and accountability.
- Assisted in the recruitment and selection of new claims analysts, ensuring they possessed the necessary skills and expertise to excel in their roles.
- Fostered a positive work environment that promoted collaboration, teamwork, and open communication among staff members.
- Enhanced team productivity by providing ongoing training and mentorship to claims analysts.
- Investigated, evaluated and adjusted multi-line claims in accordance with standards and laws.
- Conducted regular audits of claim files, ensuring compliance with company policies and industry regulations.
- Cultivated productive relationships with stakeholders, facilitating claims lifecycle.
Training and Testing Coordinator
UCare
2016 - 2017
- Develop and implement training material and resources for over 150 analyst in the Claims Department. Conduct training classes for new hire and existing staff. Develop and maintain work instructions.
- Develop, maintain, implement and audit core training materials.
- Develop and implement tools to measure effectiveness of training sessions/classes.
- Conducted thorough research and provided accurate answers to inquiries from claims training email box, ensuring clarity and understanding.
- Partnered with leadership team to develop and execute standardized work instructions for operational efficiency.
- Identify knowledge gaps and opportunities for new and existing staff.
- Led training sessions for new and tenured staff on updated claim processing procedures.
- In collaboration with other UCare departments and committees, participate in the analysis, development, and delivery of training programs for UCare staff.
- Developed and maintained detailed documentation for testing processes and procedures.
- Trained staff on best practices for testing methodologies and tools.
- Collaborated with cross-functional teams to identify and resolve testing discrepancies.
- Mentored analysts, fostering a culture of continuous learning and improvement.
- Facilitated training and development of new testing team members while delivering ongoing mentorship.
- Increased stakeholder satisfaction through timely delivery of accurate test results and insightful recommendations.
- Facilitated effective communication between testers, developers, and stakeholders to ensure timely resolution of issues.
- Nurtured a supportive work culture through the development of strong partnerships with colleagues, clients, and stakeholders, focused on achieving common objectives in testing success.
- Worked alongside QA teams to create specialized solutions aimed at overcoming distinct challenges faced throughout the testing process.
- Exceeded client expectations consistently by delivering exceptional service and support throughout the testing process.
- Provided expert guidance on test methodologies, contributing to better understanding among team members and improved performance outcomes.
- Provided technical support to production personnel.
Senior Claims Examiner
UCare
2016 - 2016
- Adjudication of State and Medicare claims processing. Research, analyze and calculate health claims in varying complexity in accordance with plan provisions.
- Review and process complex claims.
- Assisted with processing claims of inpatient transfers for hospice and nursing home patients. Supported care teams in addressing needs related to chemical dependency. Processed claims for residential services for children and unclassified medications.
- Projects and testing of claims.
- Review monthly authorization report of authorization issues of claims processed.
- Evaluated complex claims to ensure compliance with regulatory requirements and organizational policies.
- Maintained quality score of 95% or higher for 12 months.
- Led training sessions for new examiners, enhancing team knowledge and operational efficiency.
- Collaborated with cross-functional teams to resolve disputes and expedite claims processing timelines.
- Mentored staff in effective claims examination techniques, fostering professional growth within the team.
- Reduced claim resolution time by conducting thorough investigations and timely decision making.
- Mentored new hires during their onboarding process, sharing insights from years of experience as a Senior Claims Examiner.
- Implemented training programs to enhance examiner skills and improve overall performance levels.
- Reviewed policy coverage details meticulously, ensuring accurate determination of benefits payable in each case.
Claims Examiner - Team Lead
UCare
2014 - 2016
- Enhanced program outcomes by effectively analyzing and calculating state medical assistance programs, including Prepaid Medical Assistance (PMAP) and MinnesotaCare. Achieved streamlined operations through strategic evaluation of Minnesota Senior Health Options (MSHO) and Minnesota Senior Care Plus (MSC+). Improved healthcare delivery by optimizing UCare for Seniors and Connect Health Plans.
- Review medical claims for Medicaid, Medicare and Commercial insurance for coordination of benefits.
- Developed and delivered targeted Q&A resources for state claim examiners to improve operational effectiveness.
- Maintained quality standard 95% or higher for 12 consecutive months.
- Executed project completion and testing processes within established timelines.
- Analyzed claims for accuracy and compliance with policies and regulations.
- Reviewed documentation to ensure completeness and proper processing of claims.
- Developed training materials for new staff on claims processing procedures.
- Mentored junior examiners, fostering knowledge sharing and professional growth.
- Led initiatives to optimize claims adjudication, resulting in improved turnaround times.
- Handled sensitive information with discretion, ensuring confidentiality of personal and financial details for claimants throughout the claims examination process.
- Utilized analytical skills to evaluate medical bills for accuracy and appropriateness of charges before approving payments as part of the claims process.
- Enhanced customer satisfaction by promptly addressing inquiries and providing accurate information on claim status.
- Mitigated fraud risks by identifying suspicious patterns in claims data and escalating concerns to appropriate teams for further investigation.
- Examined photographs and statements.
- Conducted thorough investigations of complex claims and gather relevant documentation when necessary.
- Served as a mentor to junior examiners, sharing expertise and providing guidance on best practices within the field of claims examination.
- Assisted in the development of training materials for new Claims Examiners, fostering a supportive learning environment.
- Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
Operations Supervisor
Accent
2007 - 2013
- Directly train and manage the performance of both local and remote associates to ensure internal and external metrics are attained. Responsible for reviewing associates KPI’s (Key Performance Indicators). Facilitate weekly staff meeting, evaluate associate’s performance, and makes recommendations for promotions.
- Provide guidance, motivation and coaching for 16 - 33 associates to achieve high quality performance.
- Responsible for personnel issues including new hire training, staff training, disciplinary actions, and workflow assignments.
- Established a supportive atmosphere that fosters open dialogue and enhances teamwork among employees.
- Developed and implemented work schedules to enhance operational efficiency and employee skill application.
- Coordinated training sessions for validation staff, emphasizing key factors affecting the efficiency of the recovery team.
- Implement process and changes within the department which focuses on decreasing quality errors.
- Responsible for overseeing the implementation of new client portfolios.
- Oversaw daily operations to ensure efficient workflow and adherence to safety standards.
- Trained and mentored staff on operational procedures and best practices.
- Coordinated cross-departmental collaboration to streamline operations and resolve issues.
- Analyzed performance metrics to identify trends and initiate corrective actions.
- Developed training materials to enhance staff knowledge and operational efficiency.
- Led initiatives for continuous improvement, fostering a culture of accountability and teamwork.
- Established and nurtured communication channels with upper management to ensure timely updates regarding operational advancements and obstacles encountered by the team.
- Enhanced team productivity by providing ongoing training, coaching, and mentoring to staff members.
- Led continuous improvement initiatives aimed at reducing waste, increasing efficiency, and enhancing overall productivity levels within the organization.
- Developed strong relationships with key customers to better understand their requirements and tailor services accordingly.
- Boosted employee morale and engagement through development of comprehensive rewards and recognition program.
- Conducted performance evaluations, providing constructive feedback and identifying areas for improvement.
- Ensured compliance with industry regulations and standards, maintaining company's reputation and avoiding penalties.
- Developed and implemented training program for new hires, accelerating their time to full productivity.
- Led cross-functional teams to improve project execution, enhancing overall operational efficiency.
- Hired, managed, developed and trained staff, established and monitored goals, conducted performance reviews and administered salaries for staff.
Claims Validator
Accent
2002 - 2006
- Responsible for identifying and validating potential overpayments or incorrectly paid insurance claims; made inquiry calls to providers to determine status of claim payment; cooperate with team members to meet goals or complete tasks.
- Identified and validated potential overpayments on or incorrectly paid insurance claims, processed claims according to established process and procedures.
- Facilitated effective handling of complicated contract matters and significant claims as head of hot edit team for three years.
- Made inquiry calls to providers to determine status of claim payments.
- Calculated the amount of the overpayment given regulations and customers system access.
- Analyzed financial records to identify overpayments and directed them to overpayment department for resolution.
- Participated on special projects that develop new policies and procedures.
- Supported various departments by providing assistance during critical situations.
- Streamlined claims validation process, resulting in a 25% reduction in errors and rework.
- Ensured compliance with quality standards during validation processes.
- Collaborated with cross-functional teams to streamline operational workflows.
- Conducted thorough documentation reviews to maintain accuracy in records.
- Mentored staff in advanced validation techniques, fostering skill development.
- Managed a team of junior validators, providing guidance on best practices and overseeing their work to maintain high levels of accuracy across all projects they were involved in.
- Conducted regular audits of validation processes to identify areas for improvement and increase efficiency.
- Supported system upgrades by validating new features and functionality, ensuring seamless transitions without compromising data integrity.
- Improved validation accuracy by diligently reviewing and analyzing data for completeness and correctness.
- Maintained exceptional attention to detail while reviewing large volumes of complex information for accuracy and consistency.
- Collaborated on Standard Operating Procedure (SOP) development, incorporating input from Hot Edit team to reduce liability and enhance successful deployments.
- Explained highly complex information in terms easily understood by non-technical personnel.
- Collaborated with cross-functional teams for identification and resolution of validation issues.
- Trained and guided onsite and offshore team members in quality assurance standards, policies and procedures.
Education
Business Microcomputer Application - Business
Kankakee Community College
Kankakee, IL2001
Skills
- IPPS-Pricing Methodology
- CMS proficiency
- System configuration
- Amisys software expertise
- Key performance indicators
- Experienced in Microsoft Teams collaboration
- Experienced with MS Office applications
- HealthRules expertise
- SharePoint administration
- User acceptance testing execution
- Curriculum development
- Training and Development
- Appeals process management
- Medical Terminology
- Medicaid program management
- Organizational development
- E-learning design
- Onboarding programs
- Learning management systems
- Curriculum design
- Teamwork and collaboration
- Effective, verbal and written communication
Certification
- Licensed Notary Public Commission - 2021
- Licensed Closing Agent - 2021
Timeline
Learning & Development Specialist Senior
UCare
01.2020 - 2025
Claims Supervisor
UCare
2017 - 2020
Training and Testing Coordinator
UCare
2016 - 2017
Senior Claims Examiner
UCare
2016 - 2016
Claims Examiner - Team Lead
UCare
2014 - 2016
Operations Supervisor
Accent
2007 - 2013
Claims Validator
Accent
2002 - 2006
Business Microcomputer Application - Business
Kankakee Community College
AWARDS
CEO Roundtable Award Winner 2021
Hats Off To U Award 2015 - 2025
West Asset Management Star Award 2011
TRAINING / COURSES
Business Microcomputer Applications