Rebecca Loving-Young
Shawnee,KS
Summary
Accomplished leader with a proven track record at Charter Communications, adept in operations management and fraud prevention. Excelled in enhancing customer experience and operational procedures through strategic planning and process improvement. Skilled in Salesforce and team building, successfully driving performance and compliance across multiple teams. Demonstrated ability to mentor and develop staff, achieving significant improvements in efficiency and quality control.
Overview
12
12
years of professional experience
Work History
Supervisor Fraud Operations
Charter Communications
10.2021 - Current
- Responsible for performing research on data and thorough interaction with callers.
- Partnering with Operations Managers. Analyst, and Sr. Director to discuss implementation transformation ideas for growth.
- Assist in identifying cases of potential takeover, ID theft, or abuse.
- Consistently supports all efforts to simplify and enhance the customer experience.
- Leverage appropriate resources to support, identify, and initiate fraud or abuse investigations, and ensure relevant information is appropriately collected, analyzed, and documented.
- Review of KPIs for investigators and coaching for accuracy and feedback.
- Bring resolution to fraudulent claims by employing tools that detect and disrupt fraud schemes (ATO, payment fraud, reshipper scam, mule, etc.).
- Evaluate, process, and document fraud, identity theft, and customer validation claims.
- Utilize metrics for tracking and reporting.
- Assist with escalation calls, emails, and corporate escalations.
- Identify and present opportunities for improved operational procedures, inside and outside the department.
- Assist with ongoing coaching, development, and training side by side.
Supervisor Case Management
Centauri Health Solution
01.2020 - 10.2021
- Recommends annual scorecards components and manages necessary approved changes
- Monitors and analyzes goals/key performance indicators and reviews monthly performance
- Maintains and monitors data integrity and referrals in all appropriate Information Systems
- Conducts quality audits on a routine basis
- Looks for performance trends and acts accordingly
- Review quality audits on a routine basis
- Conducts team and individual meetings on a regular basis to communicate best practices, overall concerns, goal attainment, etc
- Assesses ongoing performance of associates, provides coaching and counseling, and recommends training
- Manages workload capacity to ensure proper utilization of resources (including transition plans)
- Handles account work and caseload for team members who are absent
- Monitors and measures change
- Provides regular and on-going technical training to Associates
- Participates in interviewing and selection of staff
- Review and approves time sheets in relation to budget
- Review and approves expense reports in relation to budget
- Recommends changes to technology to improve service line performance and effectiveness
- Responsible for current client customer satisfaction at the appropriate team level, particularly as it relates to the performance of the team
- Maintains awareness of level of success in meeting goals and in meeting client expectations
- Updates appropriate leadership on activities, issues, and concerns
- Reviews account processing procedures, recommends and implements needed changes
- Identifies opportunities for cross-team productivity
- Works with other Team Leader(s) to manage overall workload
- Interacts with Quality Coordinator to ensure cases are processed to meet quality expectations
MDS Compliance Team Lead-NC Market
Senior Dental Care
05.2019 - 01.2020
- Oversee and facilitate the completion of resident assessments in nursing facilities
- Oversee compliance of 285 facilities
- Ensure compliance with Federal and state laws
- Training on boarding new hires
- Provide update and track facility census and new admissions information provided by Hygienist or Market Manager
- Create new residential accounts
- Advanced knowledge of Salesforce, CRM, NCTracks, Point Click Care, and other EMR systems
- Working as a liaison between Market Manager, compliance team manager, clinical team, hygienist as well as nursing facilities in the North Carolina region
Lead Customer Care Advocate
Alliance Data
11.2016 - 05.2019
- Managing team customer service representative
- Resolve all escalated calls
- Oversee team member productivity and training
- Monitor employee performance and note areas for improvement
- Train OBJ with new hires
- Assist in problem solving and researching customer-based escalations
- Assist with inbound calls during high call volumes
- Provide set up for meetings with staff
- Collection of payment processing for customer accounts
- Explanation of credit card services, as well as, detail explanation of client payment processing and repayment options
- Initiate fraud claims, identify and educate on different types of fraud
- Ensuring associates follow through with attendance policy and SLA agreements
PSR Lead
Triwest Healthcare Alliance
10.2015 - 11.2016
- Oversee team members who provide insurance/authorization clarification for billing with Medicaid, commercial insurance, etc
- Facilitate coaching calls and setting calls for adherence
- Handling escalated calls and insuring Medicaid coverage for ICD9/ICD10, HCPC, CPT Codes and VA authorization forms
- Walking the call center floor to assist PSR’s during calls
- Conduct monthly QA’s and team reviews
- Assisting senior leadership with meetings and report documents
- Ensuring associates follow through with attendance policy and SLA agreements
End-to-End PSR Representative
CVS Health
01.2013 - 10.2015
- Training, support and coaching of PSR’s in call calibrations
- Setting goals for performance review
- Collections of payment via debit and credit cards
- Walking the call center floor to for assistance
- Creating documents for team building
- Assisting with calls when volume is heavy
- Verify insurance, creating new patient account, as well as, verify copay assistance to assist patient with low cost options
- Demonstrating proficiency with medical management systems for tracking and updating medical documentation via patient encounter
- Handling escalated calls from VA Hubs, Providers offices, and patients
- Ensuring associates follow through with attendance policy and SLA agreements
Education
Project Management -
Alison
06.2023
High School -
Beaumont High School
St. Louis, Mo05.2002
Master of Science - Business Administration And Management
Purdue University
OnlineSkills
- Leadership
- Training
- Development
- Typing
- Microsoft Word
- Microsoft Excel
- Microsoft Access
- Microsoft PowerPoint
- Microsoft Outlook
- Spreadsheets
- WPP
- TLO
- SharePoint
- CRM
- ERM
- PCC
- Dayforce
- Kronos
- Lexus Neux
- Fraudnet
- CSG
- Agentos
- Matrix
- Salesforce
- Schedule development
- Employee motivation
- Strategic planning
- Documentation and reporting
- Process monitoring and improvement
- Operations management
- Quality control
- Expectation setting
- Conflict resolution
- Processes and procedures
- Data analytics
- Employee development
- Payroll processing
- Workflow management
- Staff discipline
- Verbal and written communication
- Policy and procedure development
- Negotiation
- Team building
- Process improvement
- Attention to detail
- Training and mentoring
- Customer service
- Analytical thinking
- Performance management
- Decision-making
- Relationship building
- Staff development
- Risk management
- Policy enforcement
- Coaching and mentoring
- Task delegation
- Complex Problem-solving
- Project planning
- Staff management
- Project management
- Public speaking
- Goal oriented
- Department organization
Phone
913-275-0674, 913-415-1671
Timeline
Supervisor Fraud Operations
Charter Communications
10.2021 - Current
Supervisor Case Management
Centauri Health Solution
01.2020 - 10.2021
MDS Compliance Team Lead-NC Market
Senior Dental Care
05.2019 - 01.2020
Lead Customer Care Advocate
Alliance Data
11.2016 - 05.2019
PSR Lead
Triwest Healthcare Alliance
10.2015 - 11.2016
End-to-End PSR Representative
CVS Health
01.2013 - 10.2015
Project Management -
Alison
High School -
Beaumont High School
Master of Science - Business Administration And Management
Purdue University
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