Coordinator Technical Support Claims
Current• Managed Commercial Claims operations by overseeing the recruitment, development, and performance of clerical staff, ensuring alignment with department objectives. • Provided leadership and technical guidance, assuming full supervisory responsibilities in the absence of the direct claims supervisor.• Led cross-functional teams to implement workflow improvements, utilizing performance metrics to set goals SCRUM/SPRINTS methodologies for agile project management, monitor progress, and ensure the achievement of key outcomes. • Fostered a collaborative and motivating work environment. • Directed the development, implementation, and optimization of claims processing systems, coordinating project activities across multiple departments to ensure seamless execution and efficient workflow. • Conducted system audits and user assessments to enhance program quality, improve production standards, and optimize system utilization. • Investigated and resolved claim-related issues to ensure operational efficiency. • Provided expert training and support on system functionality, including claims systems and DEC applications. • Developed and revised program procedures based on data analysis, ensuring continuous improvement and alignment with business needs. • Analyzed performance reports, identified trends, and worked with management to implement strategic solutions. • Acted as a liaison between teams and leadership to ensure coordination, meeting deadlines, and delivering timely, accurate results. • Monitored data collection and quality through a rigorous audit process. • Managed the adjudication of claims, ensuring timely and accurate processing while continuously improving workflow processes and ensuring compliance with industry standards.
