Adaptable Manager offers 15 years of experience coordinating operations to achieve organizational goals. Communicative team leader with expertise in strategic planning and inventory management. Committed to driving improvements through innovation and leadership.
Work History
Svs Escl Acct Mgr . Contact Center Operation
UnitedHealthcare Optum Division
Atlanta, Georgia
04.2020 - Current
Leveraged leadership skills to identify deficiencies and opportunities to improve policies, procedures and controls.
Analyzed customer feedback data to develop action plans for improving services offered.
Collaborated with other departments to ensure timely completion of projects within budget constraints.
Enhanced team member performance through use of strategic and tactical approaches, motivational coaching and training.
Recruited and trained new employees to meet job requirements. care management, program coordination, patient care, Medicare Retirement Service
Maintained up-to-date records of employee attendance, payroll information, vacation requests. long-term disability, short-term disability inquiries, complaints requiring management-level escalation primary responsibilities enterprise clinical service
Handle call transfers for claims reconsiderations and member education. Contact care providers (doctor’s offices) on behalf of the customer to assist
Help guide and educate customers about the fundamentals and benefits of consumer-driven health care topics to select the best benefit plan options, maximize the value of their health plan benefits and choose a quality care provider
Assist customers in navigating UnitedHealth Group websites, encouraging and reassuring them to become self-sufficient in using our tools
Act as a Subject Matter Expert or mentor to other team members
Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims
This is a challenging role that takes an ability to thoroughly review, analyze and research complex healthcare claims in order to identify discrepancies, verify pricing, confirm prior authorizations and process them for payment. You’ll need to be comfortable navigating across various computer systems to locate critical information. Attention to detail is critical to ensure accuracy which will support timely processing of the member's claim.
Senior Benefits Specialist
TTEC
Duluth, GA
07.2018 - 04.2020
Evaluated existing policies against industry best practices and regulatory requirements; made recommendations for improvement where necessary.
Created detailed reports on benefit program utilization, costs, and effectiveness.
Oversaw enrollment of new employees and company-wide yearly enrollment period.
Coordinated with vendors to ensure that all services are provided as agreed upon in contracts.
Kept operations in compliance with requirements by applying knowledge of applicable regulations, legal statutes and tax code information.
Recruitment Consultant
Horizion Staffing
Atlanta, Georgia
05.2015 - 06.2018
Conducted initial phone interviews with potential candidates to assess their skills and qualifications.
Reviewed referral candidates and contacted qualified individuals to request applications.
Analyzed employment-related data and prepared reports.
Prepared or maintained employment records using human resources management system software.
Conducted exit interviews and completed employment termination paperwork.
Communicated clearly with employees, suppliers and stakeholders to keep everyone on same page and working toward established business goals.
Cash Vault Management
Garda World Cash Logistics
Smyrna, GA
01.2004 - 10.2015
Reviewed completed work to verify consistency, quality and conformance.
Analyzed business performance data and forecasted business results for upper management. accurate and timely reports of project activities.
Determined marketing strategies by reviewing operating and financial statements and departmental sales records.
Completed thorough opening, closing and shift change functions to maintain operational standards each day.