Sylvia Stapleton
Pittsburg,Kansas
Summary
Methodical and results-driven business process consultant with over a decade of progressive management and administration experience. Proven expertise in process optimization, financial analysis, and client relationship management. Seasoned collaborator, experienced in communication with peers, partners, brokers, and clients.
Overview
12
12
years of professional experience
Work History
Business Process Consultant
UnitedHealth Group
11.2023 - Current
- Lead multi-departmental meetings to coordinate project initiatives, ensuring objectives are met
- Lead IT budget change control process for a project with a $13 million budget
- Participate in bi-weekly governance meetings
- Define new business processes to meet requirements and drive organizational growth
- Recognize and address gaps in existing processes
- Develop and present comprehensive workflows
Service Account Manager
UnitedHealth Group
11.2022 - 11.2023
- Administered benefits for 20+ self-funded client groups, serving as their central point of contact
- Cultivated strong and lasting client relationships; saw 96% retention rate
- Ensured compliance with regulatory agencies
- Developed contracts for benefit changes and yearly renewals, and acted as consult on initial group implementations
- Generated benefit usage reports and provided cost analysis to optimize resource allocation
- Spearheaded problem-solving efforts, driving resolution to maintain client satisfaction
- Coordinated with internal departments, external vendors, and brokers to deliver seamless client experience.
Claims Specialist
UnitedHealth Group
01.2018 - 11.2022
- Acted as dedicated specialist for a large self-funded client, providing personalized service and support
- Investigated and resolved benefit concerns
- Conducted claim adjustments and managed appeals process for 3,500+ members
Assistant Manager
Shoe Sensation
06.2017 - 01.2018
- Managed daily sales operations
- Supervised and trained team of 10 employees
- Generated and analyzed sales reports to identify trends and opportunities
- Devised and executed performance improvement processes, increasing sales by average of 20%.
Claims Examiner
NTT Data
05.2016 - 03.2017
- Reviewed medical insurance claims for benefit assignment, ensuring adherence to policy guidelines and high level of accuracy.
Claims Auditor; Subject Matter Expert
Cobalt Medplans
12.2012 - 05.2016
- Audited medical insurance claims for processing accuracy
- Assigned errors to processors and provided one-on-one coaching when necessary
- Performed internal audits and analysis to identify areas of potential performance improvement
- Created workflows and hotkeys to optimize processing efficiency.
Education
BBA - Management
Pittsburg State University
Pittsburg, KansasMBA - Healthcare Administration
Pittsburg State University
Pittsburg, KS05.2025
Skills
- Project Management
- Benefit administration
- Business process improvement
- Process development and optimization
- Budget allocation
- Client relations
Timeline
Business Process Consultant
UnitedHealth Group
11.2023 - Current
Service Account Manager
UnitedHealth Group
11.2022 - 11.2023
Claims Specialist
UnitedHealth Group
01.2018 - 11.2022
Assistant Manager
Shoe Sensation
06.2017 - 01.2018
Claims Examiner
NTT Data
05.2016 - 03.2017
Claims Auditor; Subject Matter Expert
Cobalt Medplans
12.2012 - 05.2016
BBA - Management
Pittsburg State University
MBA - Healthcare Administration
Pittsburg State University
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