Wendy Kaercher
Abilene,TX
Summary
Dedicated and results-driven professional with a strong leadership background. Committed to optimizing operations and reducing costs to enhance organizational efficiency. Demonstrates independent decision-making skills and sound judgment, consistently contributing to company success. Collaborative leader who actively partners with colleagues to foster an engaged and empowering work culture. Proven ability to build and maintain relationships with diverse stakeholders in dynamic, fast-paced environments, further strengthening skill set.
Overview
28
28
years of professional experience
Work History
Appeals Customer Service Manager
Health Care Service Corporation
08.2020 - 08.2024
- Directly managed 6 supervisors
- Indirectly managed 100+ employees that report to supervisors
- Multiple project management and implementation regarding cost-savings, constantly changing Federal/State laws and regulations and Sales and Marketing initiatives to obtain and maintain business
- Oversight of payroll, time management, performance reviews, weekly feedback, review, approval and administration of employee corrective action, guidance to supervisors on employee management while enforcing corporate policies, as well as multiple state and federal laws and regulations
- Resolved customer complaints while prioritizing customer satisfaction and loyalty.
- Controlled costs to keep business operating within budget and increase profits.
- Successfully managed budgets and allocated resources to maximize productivity and profitability.
- Leveraged data and analytics to make informed decisions and drive business improvements.
- Controlled resources and assets for department activities to comply with industry standards and government regulations.
- Established positive and effective communication among unit staff and organization leadership, reducing miscommunications, and missed deadlines.
- Directed initiatives to improve work environment, company culture or overall business strategy.
Appeals Senior Supervisor
Health Care Service Corporation
12.2013 - 08.2020
- Manage teams of employees
- Expedited (immediate life or limb threatening) appeals management while maintaining compliance with the law with 24-72 hours of receipt response based off applicable state laws
- Daily partnership with lawyers, physicians, executive leadership, account executives, group plans, State of Texas partners amongst many other key stakeholders
- Coordinated, supervised and evaluated work of subordinates and reallocated staff and resources to meet performance requirements.
- Identified underperforming areas and implemented effective process improvements.
- Analyzed metrics to identify areas of opportunity, drive performance improvements and consistently exceed operational goals.
- Resolved understaffing issues, disputes, employee terminations, and disciplinary procedures.
- Maintained confidential nature of employee and company proprietary and privileged information used or observed in course of performing job duties.
- Managed full cycle of recruiting, hiring, and onboarding new employees.
- Maintained current knowledge of industry regulations and legislation to amend policies and promote compliance.
- Distributed employee engagement surveys to identify areas of improvement.
Customer Service Supervisor
Health Care Service Corporation
08.2005 - 12.2013
- Manage teams of employees
- Complete administrative work for employees, such as payroll, monthly feedback, mid-year and Yearly performance reviews
- Monitoring and coaching of employees, while complying with all laws and regulations
- Coached employees through day-to-day work and complex problems.
- Coached team members to deliver hospitable, professional service while adhering to set service models.
- Built highly-efficient administrative team through ongoing coaching and professional development opportunities.
- Monitored and handled employee claims involving performance-based and harassment incidents.
- Maintained company compliance with local, state, and federal laws, in addition to established organizational standards.
- Processed employee claims involving performance issues and harassment.
- Facilitated successful policy implementation and enforcement to maintain legal and operational compliance.
- Instructed senior leaders on appropriate employee corrective steps.
- Discovered and resolved complex employee issues that affected management and business decisions.
Claims/Customer Service Coordinator
Health Care Service Corporation
03.2003 - 07.2005
- Review all materials received to see if applicable to department (laws, regulations, state mandates
- Update guidelines as applicable
- Service Observe phone calls to identify training issues
- Responded to customer needs through competent customer service and prompt problem-solving.
- Trained and regularly mentored associates on performance-oriented strategies and customer service techniques.
- Collaborated with upper management to improve customer service processes and support structures company-wide.
- Coordinated individual duties after careful evaluation of each employee's skill level and knowledge.
- Collaborated with staff members to enhance customer service experience and exceed team goals through effective client satisfaction rates.
- Reduced process inconsistencies and effectively trained team members on best practices and protocols.
- Trained staff on operating procedures and company services.
Customer Service Technician
Health Care Service Corporation
09.1999 - 03.2003
- Provided prompt support for the customer service representatives to assist with resolution of complex customer inquiries.
- Created and maintained reports of customer service performance for Sr. Leadership
- Monitor phone call program to ensure availability for the customer
- Implemented and developed customer service training processes.
- Prepare daily reports for supervisors
- Develop training programs for employees
- Increased efficiency and performance by monitoring team member productivity, phone call quality and providing feedback.
- Optimized customer support by establishing collaborative service environments through targeted operational initiatives.
- Cross-trained and provided backup support for organizational leadership.
Claims Examiner I
Health Care Service Corporation
09.1998 - 12.1998
- Processed claims in a timely and efficient manner
- Surpassed the learning curve in a short time and promoted within 3 months of working within the company
- Researched claims and incident information to deliver solutions and resolve problems.
Clerical Technician/Timekeeper
Concepts of Care
02.1997 - 09.1998
- Ordered medical supplies and durable medical equipment for clients according to their needs
- Created a more efficient system of filling clients orders to be received on a timely basis
- Payroll for the nurses and CNAs
Education
High School Diploma -
Abilene Cooper High School
Abilene05.1994
Skills
Budgeting and forecasting
Complaint resolution
Customer service
Employee management
Employee onboarding
Employment and labor laws
Federal/State laws and mandates
HR policy development
Networking strategies
Payroll coordination
Performance monitoring and reporting
Personnel recruitment
Project Management
Staffing coordination
Team leadership
Training and mentoring
Workforce planning
Timeline
Appeals Customer Service Manager
Health Care Service Corporation
08.2020 - 08.2024
Appeals Senior Supervisor
Health Care Service Corporation
12.2013 - 08.2020
Customer Service Supervisor
Health Care Service Corporation
08.2005 - 12.2013
Claims/Customer Service Coordinator
Health Care Service Corporation
03.2003 - 07.2005
Customer Service Technician
Health Care Service Corporation
09.1999 - 03.2003
Claims Examiner I
Health Care Service Corporation
09.1998 - 12.1998
Clerical Technician/Timekeeper
Concepts of Care
02.1997 - 09.1998
High School Diploma -
Abilene Cooper High School
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