Celeste Holmes Email & Phone Number

Acts as a single-point-of-contact for escalated member-specific issues and/or broader plan administration matters.Support installation of new and existing accounts for the site by attending implementation planning/process meetings.Proactively identify and surface customer and plan issues for resolution while acting as a liaison to communicate workflow results, ideas and solutions.Proactively analyzes constituent data, identifies trends and issues.Establishes corrective action plans/reporting for issue resolution.Identifies most urgent business problems, obtains necessary information and accurately identifies root causes and generates solutions.Initiates and maintains partnerships with others throughout the organization.Encourages cooperation by promoting common goals and building trust. Inspires, supports, and initiates cross functional activities.Handles escalated network issues and member balance billing issues

Harrisburg, Pennsylvania Area

Primarily responsible for the daily management of 15 + plus direct reports. Managed performance and metrics for my team.Develop daily team huddles and conduct bi-weekly 1:1 meeting with my direct reports. Responsible to facilitate leadership meetings once a month. Responsible for strategic planning and implementation across my department. Give constructive feedback on team performances. Actively listen to my team concerns about their daily challenges. Assist in hiring and mentoring new candidates in their job responsibilities.Assist in employee performance evaluation, promotion, retention, and termination activities. Monitor individual performance and ensure it meets expected quality and performance objectives and goals.

Team Lead providing technical and functional leadership within unit.Works collaboratively with internal/external constituents to implement new networks and complex contractual arrangements.Conducts and manages audits of provider information and escalates issues for resolution as appropriate.Directly contacts providers and/or outside vendors to clarify data quality issues when needed.Complete root cause analyses by identifying trends caused by providers who routinely bill services inaccurately. Collaborates cross-functionally within the organization to recommend process improvementsPerforms validation of system enhancements.Demonstrated ability to handle multiple assignments. Maintains and updates provider demographic and contract information, including contractually sensitive or complex transactions, in appropriate systems in support of claims adjudication and provider directory.Provides operational support and performs data maintenance for data transactions (basic to complex). In addition, performs data transactions and maintenance associated with projects, expansions, and new product implementations.

Harrisburg, Pa, United States

Working in a call center environment.Talk to providers and members on daily basis.Major contact person for big employer group.Take supervisor calls.Mentor for new hires.Project leader on new initiatives. Process medical claims for members and providers.Assist with special projects for upper management.Experience in working with Medicare plans.Answer broker hotline phone calls and email request.

Working in a call center environment.Talk to providers and members on daily basis.Commerical and Medicare phone calls.

Bachelor Of Business Administration (Bba), Business Administration And Management, General

Computer Science

High School Diploma