Dynamic Operations leader with a demonstrated history of building customer focused high performing teams in the insurance industry. Proven success building and driving service strategies that contribute to organizational growth and success.
Overview
21
21
years of professional experience
Work History
Director, Leave Solutions Claim Operations
Alight Solutions
03.2022 - Current
Spearhead Global Leave of Absence, COVID, and Maternity Claim Centers of Excellence utilizing deep technical claim knowledge to create efficient workflow strategies to achieve KPI’s while adhering to compliance standards and industry best practices.
Director, Leave Solutions Customer Care Operations
Alight Solutions
01.2022 - 01.2024
Deliver transformational leadership to a high performing customer obsessed team comprised of 7 managers and 150 agents, responsible for nearly 2 million inquiries a year through multi-channel outreach including phone, chat and email
Partner cross-functionally to develop and execute an innovative call and claim operational strategy roadmap focused on improving the end-to-end customer experience through technology, key service performance metrics, workforce management dexterity, vendor agility, and employee engagement.
Director, Claims and Customer Service
Blue Cross Blue Shield of South Carolina
01.2012 - 01.2022
Drove creation and execution of the operational strategy for dental product offerings across the organization
Managed overhead costs and PMPM targets through continuous operational and technological improvements
Directed and led the day-to-day operations of multi-location customer service, corporate claims and development, testing, and appeals teams for medical and dental products; responsible for administering benefits for individual, small group and large group clients
Utilized coaching and data metrics to influence teams to focus on continuous service and quality improvements across the book of business
Built strategic partnerships with other Blue Plans and vendors to promote business growth while serving as business lead for strategic initiatives.
Manager, Claims and Customer Service
Blue Cross Blue Shield of South Carolina
01.2008 - 01.2012
Led the TPA team administering ancillary products for fully insured and ASO national business
Responsible for claims, customer service, books and contracts, provider files, enrollment and billing for small and large group voluntary benefits
Launched individual dental product and implemented two new Blue business partners, expanding membership growth by 230%.
Supervisor, Claims and Customer Service
Blue Cross Blue Shield of South Carolina
01.2006 - 01.2008
Team Leader, Claims and Customer Service
Blue Cross Blue Shield of South Carolina
01.2005 - 01.2006
Customer Service Representative
Blue Cross Blue Shield of South Carolina
01.2004 - 01.2005
Education
Bachelor of Science - Business-Healthcare Management
Western Governors University
Skills
Strategic Planning
Verbal and written communication
People Management
Operations Management
Project Management
Budget Control
Business Planning
Legal and Regulatory Compliance
Timeline
Director, Leave Solutions Claim Operations
Alight Solutions
03.2022 - Current
Director, Leave Solutions Customer Care Operations
Alight Solutions
01.2022 - 01.2024
Director, Claims and Customer Service
Blue Cross Blue Shield of South Carolina
01.2012 - 01.2022
Manager, Claims and Customer Service
Blue Cross Blue Shield of South Carolina
01.2008 - 01.2012
Supervisor, Claims and Customer Service
Blue Cross Blue Shield of South Carolina
01.2006 - 01.2008
Team Leader, Claims and Customer Service
Blue Cross Blue Shield of South Carolina
01.2005 - 01.2006
Customer Service Representative
Blue Cross Blue Shield of South Carolina
01.2004 - 01.2005
Bachelor of Science - Business-Healthcare Management