Patrick George
San Diego,CA
Summary
Results-oriented Process Improvement Professional with over 20 years of experience in optimizing business operations and enhancing customer service. Expertise in analyzing processes, identifying improvement opportunities, and implementing effective solutions. Skilled in training and developing teams, collaborating with stakeholders, and driving sustainable change through strategic process enhancements.
Overview
21
21
years of professional experience
Work History
Senior Account Administration Representative
Kaiser Permanente
San Diego, California
06.2023 - Current
- Provided subject-matter expertise to account administration representatives regarding processes and procedures.
- Resolved escalated issues through root cause analysis and development of effective solutions.
- Collaborated with Team Managers and Team Leads to coordinate daily operations, address risks, and maintain service expectations.
- Communicated and trained employees and contract workers on new and revised processes to support effective change adoption.
- Managed team inventory in EMWS while overseeing priorities, deadlines, and operational requirements.
- Evaluated daily operational workload to optimize work delegation and ensure alignment with business objectives.
- Collaborated with Analysts on DLP revisions and process documentation to enhance clarity and consistency in operations.
- Supported implementation of process changes by communicating requirements and answering questions.
Account Administrative Representative
Kaiser Permanente
San Diego
01.2023 - 05.2023
- Managed complex membership transactions including enrollments, corrections, retroactivity adjustments terminations and refunds while ensuring adherence to established procedures.
- Researched eligibility and billing issues, collaborating with MSCC and internal partners to resolve process-related issues efficiently.
- Resolved SharePoint escalations by analyzing issues, researching requirements, and coordinating appropriate resolutions.
- Provided timely and accurate information on membership and billing processes to support Small Groups and brokers.
- Assisted CA FAMM with termination and refund processes, identifying discrepancies and ensuring accurate processing outcomes.
Interim Sr Account Administration Representative
Kaiser Permanente
San Diego
07.2021 - 12.2022
- Coordinated daily workflow, evaluated workloads, and delegated assignments to align with business priorities and operational capacity.
- Managed team inventory in EMWS and CHATS while monitoring operational workload and service requirements.
- Identified and resolved operational issues with internal and external partners, enhancing efficiency and customer satisfaction.
- Reviewed and processed retroactive membership exception requests requiring detailed research, analysis, and adherence to established business rules.
- Facilitated team huddles, department strategy discussions, and leadership meetings to communicate priorities, issues, process changes, and operational updates.
- Communicated new and revised processes to employees and contract workers and supported adoption of process changes.
- Provided performance feedback to Team Manager and identified opportunities for employee development.
- Participated in team-based projects and operational improvement initiatives.
- Collaborated with Analysts on DLP revisions and process improvements, helping ensure procedures accurately reflected current business processes.
- Collaborated with Team Managers, Team Leads, Analysts, and operational partners to identify issues and implement effective solutions.
Account Administration Representative
Kaiser Permanente
San Diego, California
04.2015 - 07.2021
- Managed member data, ensuring accuracy in enrollments, corrections, retroactivity adjustments, terminations, and refunds to support seamless service delivery.
- Analyzed eligibility and billing issues and collaborated with internal partners to research and resolve discrepancies.
- Performed manual membership processing while maintaining accuracy and compliance with established procedures.
- Resolved SharePoint escalations through thorough research and cross-functional collaboration, enhancing issue resolution processes.
- Identified recurring process issues and collaborated with team and leadership to streamline process execution and enhance overall efficiency.
Account Administration Representative
Kaiser Permanente
San Diego, California
07.2012 - 04.2015
- Conducted Quality Assurance (QA) reviews of Purchaser Advices from other Account Administration Representatives, enhancing overall processing accuracy.
- Identified processing errors and offered targeted feedback to enhance accuracy and consistency in future submissions.
- Processed web-loaded and manual Purchaser Advices for enrollments, renewals, amendments, maintenance, ensuring compliance with established guidelines.
- Assisted other lines of business with Membership Eligibility processing and resolution.
Account Administration Representative
Kaiser Permanente
San Diego, California
12.2009 - 07.2012
- Conducted quarterly User Acceptance Testing (UAT) to ensure system and process changes met requirements before implementation.
- Analyzed information and validated data to ensure accuracy in reporting and alignment with business requirements.
- Researched Group Tax IDs and compiled necessary information for reporting to Centers for Medicare & Medicaid Services (CMS) to maintain compliance.
Account Administration Representative
Kaiser Permanente
San Diego, California
02.2006 - 12.2009
- Managed an assigned Book of Business portfolio, ensuring accurate and timely account administration.
- Executed financial reconciliation and investigated discrepancies to ensure accurate account and billing information.
- Performed payment allocations and resolved complex account issues.
- Handled EM transactions and manual membership changes to maintain seamless account operations.
- Maintained Large Group billing information and supported ongoing account requirements.
- Addressed escalated issues through research, analysis, and collaboration with internal partners to enhance resolution effectiveness.
- Provided customer service and operational support to Sales and Account Managements teams.
Education
High School Diploma -
Guam Community College
Mangilao, Guam12-1992
Skills
- Business Process Management
- Process Improvement & Optimization
- Operational efficiency
- Process analysis
- Process Change Coordination
- Process Quality Review
- Business analysis
- Risk resolution
- Membership Management
- Customer experience
- Continuous improvement
- Training and mentoring
Timeline
Senior Account Administration Representative
Kaiser Permanente
06.2023 - Current
Account Administrative Representative
Kaiser Permanente
01.2023 - 05.2023
Interim Sr Account Administration Representative
Kaiser Permanente
07.2021 - 12.2022
Account Administration Representative
Kaiser Permanente
04.2015 - 07.2021
Account Administration Representative
Kaiser Permanente
07.2012 - 04.2015
Account Administration Representative
Kaiser Permanente
12.2009 - 07.2012
Account Administration Representative
Kaiser Permanente
02.2006 - 12.2009
High School Diploma -
Guam Community College