Peter Heddles

• Collaborated with management and peers to identify trends for root cause analysis and resolution.
• Worked with team to implement policies ensuring timely resolution of outstanding accounts.
• Developed new processes with management to enhance operational efficiency.

• • Developed comprehensive reporting levels that improved visibility into operational KPIs for better decision-making.
  • Reviewed productivity and quality trends, identifying variances and implementing risk mitigation solutions.
  • Created database scripts and Excel tools that streamlined quality task management execution, enhancing workflow efficiency.
  • Generated analyses that optimized turnaround times for identifying coaching process gaps and integrating feedback from reports.
  • Established standard operating procedures and job aids to control technical processes within the organization.

• Managed projects for HCC Medicaid, ACA, RACCR, and commercial initiatives, ensuring alignment with organizational goals.
• Designed reports with SQL, Excel, Access, and Tableau to track inventory and production trends.
• Trained and mentored new supervisors in reporting and key responsibilities.
• Streamlined team workflow, minimizing disruptions for stakeholders and enhancing operational efficiency.
• Developed database scripts and business tools in Excel for inventory management and deadline tracking.
• Identified gaps in coding processes by analyzing operational financial and QA reports.
• Authored training manuals and job aids for supervisor support.
• Developed standard operating procedures to improve technical process control and ensure consistency across operations.

• Managed a team of 200 in inbound call center for healthcare insurance claims.
• Monitored quality goals, resolving customer inquiries, complaints, and provider surveys.
• Trained customer service agents on corporate protocols and interpersonal skills.
• Designed monthly, quarterly, and yearly reports for departmental key performance indicators.
• Departmental reports presented to senior staff and clients, highlighting performance outcomes.
• Collaborated with management and IT to implement innovative software solutions for new clients.
• Oversaw departmental budget, including headcount forecasting, payroll, and overtime allocation.

• Reduced AR dates from 190 to 42 days within five months, enhancing cash flow efficiency.
• Streamlined processes for new code tracking and billing software rollout, improving user adoption.
• Reduced data entry errors, leading to less rework and fewer medical claim refilings.
• Enhanced accounts receivable management, directly contributing to overall revenue growth.

• Led cross-functional teams to enhance customer service efficiency and streamline processes.
• Identified, investigated, and resolved inquiries regarding benefit claims and approvals.
• Trained employees in contract language and conflict resolution strategies.
• Oversaw compliance team to ensure adherence to state grievance laws and timely responses.
• Analyzed error types to minimize administrative errors affecting financial liability.
• Oversaw departmental budget with emphasis on headcount forecasting and overtime management.