Barbara Schack Email & Phone Number

Hellerup, Capital Region, Denmark

Toronto, Canada Area

Project: Implementing a GDPR compliance CRM and Claims software including auto-adjudication, optical character recognition, and tailor-made insurance policies and products to support the company’s objective to become a leader within the IPMI industryAssignments:Communication and coordination between Clients, Development units and Production areas. Created Business requirements documents and Functional Specification documents.Participated in the Sprint planning sessions.Analyzing the current process and potential impact of changes to current service platform incl. the digital platform. Created test cases and performed manual testing.Performed analysis to identify production issues and worked with development teams to determine the solution. Project lead on Operations & Maintenance, change requests, new and enhancements projects.

Toronto, Canada Area

Managing the provision of effective, quality-driven assistance services to clients and members to ensure smooth day-to-day business operations.Key to the role was maintaining a strong work ethic and acting with a sense of urgency and purpose, balanced with strategic and day-to-day intent.

Toronto, Canada Area

TPA Specialist and Supervisor, executing change management projects while overseeing a dynamic team of claims specialists.

Canada

Miami, Florida

Lead a newly integrated claims processing department consisting of 5 teams with 100 employees by planning, coordinating and delivering claims management strategies for BUPA International Latin American portfolio by:• Evaluate claim department processing in Miami and at Service Centers, identify areas for im-provement and efficiencies, initiate change and secure implementation in order to exceed service expectations.• Establish and cultivate relationships with key partners, e.g. United Healthcare International and producers • Establish and monitor department key performance standards, set and communicate objec-tives, and devise strategy for achieving them. • Run and evaluate claims pending reports to ensure claims processing is in line with department requirements, objectives and deadlines.• Guarantee quality and timeliness of processing by reviewing processes and ensuring checks and balances are in place. • Ensure processing is in compliance with company procedures and the confines of the policy and medical diagnosis. Monitor that reimbursement or payout is within network rates or the usual and customary rates• Execute and share a full understanding of the company’s products, policies and procedures and share with staff to develop their level of competency. • Utilize resources such as ICD-9, CPT, Physicians fee guide and other resources when reviewing claims• Evaluate staff’s performance, coach, motivates and counsel employees to ensure performance is optimized. Create a work atmosphere where individual and team effort is recognized and re-warded.During employment member of:• The Management Team Bupa Latin America• The HIPAA Compliance Committee• High Value Claims Committee

Miami, Florida

Support and guide a new management team while insuring consistency in the management of three different product lines under two different legal entities by:•Enabler as advisor and subject matter expert in all areas related to Premier 1 policies and procedures.•Explain existing Premier 1 processing procedures, and ensures effective transition to Bupa process.•Provide support, and training for Associates as needed to increase knowledge of Premier 1 products and proficiency in processing policies, claims, processing, etc.•Provide guidance and full assistance in resolving complex issues for Premier 1 products.• Assist to transition relationships with Premier 1 Agents, Policyholders and Providers as needed. •Support data migration project from PSI to AMIGOS.•Documents processes and create/update manuals for Premier 1 product suite.•Provides training on PSI system, monitors information entered into system when required, tracks errors and suggests corrective measures.•Monitors and evaluates trends, identifies potential areas that can cause errors in processing, procedures, and makes recommendations to Management for changes or adjustments.• Approve of high value claims by verifying all credentialing documentation is received and is within TPA compliance.•Interacts with Team managers to assure consistency across the different policies and assist with exceptions or administrative decisions.Courses during employment:• PMP® Exam Preparation Course• Introduction to Project Management through PMP® methodology

Miami, Florida

Lead a new TPA Claims department for all ihi Bupa Latin America claim. Delivering claims management strategies in accordance with the TPA Service Level Agreement by:• Establish a framework of processes and measurements to insure TPA compliance.• Establish and monitor department key performance standards, set and communicate objectives, and devise strategy for achieving them. • Run and evaluate claims pending reports to ensure claims processing is in line with department and TPA requirements, objectives and deadlines.• Guarantee quality and timeliness of processing by reviewing processes and ensuring checks and balances are in place. • Ensure processing is in compliance with company procedures and the confines of the policy and medical diagnosis. Monitor that reimbursement or payout is within network rates.• Implementation of usual and customary rates on the Premier 1 product suites.• Execute and share a full understanding of the Premier 1 product suite, policies and procedures and share with staff to develop their level of competency. • Evaluate staff’s performance, coach, motivates and counsel employees to ensure performance is optimized. • Create a work atmosphere where individual and team effort is recognized and rewarded.Courses during employment:• Leading Our People: Six month management program with specific focus on cultural differences • Cultural Awareness: Learning to see cultural differences as an enabler rather than an impediment to successful business cooperation

Copenhagen, Denmark

Assumed authority for daily management, motivation, and development of the service group, coordination of communications between service groups, management, producers and policyholders in the Latin American portfolio.Contributed to the development of working procedures, overseeing mission critical cost control projects, and coaching departmental employees in taking initiative, developing skills, and embracing organizational challenges.

Copenhagen, Denmark

On-boarded and trained new team members in simple and complex claims, use of intranet, inter-agency communication, and acculturated staff in the administration of specialized products such as Optimyse (proactive health plan), Critical illness and Accident plans.Supported all teams across all service departments with processing claims with unique contractual importance.Spearheaded the first pilot project, the transfer of specific services from Copenhagen office to the Miami office and the hand over to the daily leader after six weeks training and implementation.Oversaw the full range of provider service communication between Bupa Copenhagen and Bupa Miami as well as communications between providers, ihi Bupa, and producers' use of Xtranet

Copenhagen Area, Denmark

Conducted the enrollment of new individual and corporate clients, medical underwriting, policy changes, claims handling, customer service, and special projects in training, motivating, and supporting providers of the online Buy Now Service.Mapped the workflow of ihi Bupa between 2005 and 2006 optimizing internal workflow defining various claim types, preparing for receipt of claims in all services departments and streamlining interdepartmental communications.Served as Emergency Service Consultant in providing medical evaluation in connection with verification of benefits, and liaison between emergency team and various service departments in responding to diverse challenges.

Malaga, Spain

Lead the daily communication with the mother company Sun Alliance (later Royal & Sun Alliance) to insure quality and timeliness of claims handling between the company and the agency’s clients.Key account manager for VIP clients (new business, service & claims) to insure a unique and personalized platform of a wide range of insurance products (boat, car, dog, health, home, hunting, and travel) even if it meant going outside the company in order to fulfill the VIP clients need.1998 Danican S.A. changed legal status from a Royal & Sun Alliance agency to an insurance broker. With my abilities as account manager for our VIP clients I managed to nurture relationships with other insurance companies which enabled me to on board companies such as UAP (later AXA), Winterthur and DKV health insurance.

Malaga, Spain

Recruited to reconfigure the office set up from multi-functional groups (language divided) to a front office area (service and new business) and a back office (claims). After a three months implementation phase I managed the claims area and all outbound communication with the 20+ international insurance companies which BMI held contracts with.

Bachelor In Science, International Business And Modern Languages

Internship With Michael F. Dunn, Biochemistry And Molecular Biology

Graduate Teacher Programme (750 Hours), Yoga Teacher Training/Yoga Therapy