Lead a team of several employees in the Premium Billing department. Acted as the subject matter expert for all complex issues and inquiries. Designed training documentations and held trainings for workflows and projects; both virtual and in-person. Conducted interviews of new hires/potential candidates for the team. Represented the Premium Billing department in several inter-department endeavors such as audits, meetings, projects. Worked out of relational databases such as Microsoft Access and MHK MarketProminence. Designed SQL queries to analyze data and report insights. Spearheaded several department projects to streamline processes, improve efficiency and ensure compliance. Ran the monthly invoicing procedure to bill all members for their insurance coverage.

Managed monthly premium payments made by Medicare Advantage plan members and participating employer groups in the amounts of several million dollars. Performed monthly reconciliation of said payments to locate discrepancies, and outreached to payers to resolve such imbalances. Performed quality check on new group setup, and terminations for failure of payment to appropriate parties when necessary. Reviewed and processed adjustments for accounts of members who pay via SSA or have LEP/LIS under Tufts Medicare Preferred.

Assisted established members with their health insurance benefits through Tufts. Helped navigate members through their plans, helped set up plans; worked with 65+ year old or disabled members with their Medicare/MassHealth plans. Provided customer service over the phone via an Avaya VOIP program and performed data entry. Documented calls on a secure cloud-based system. Dealt with sensitive private health information and processed expedited requests in a professional manner. Used many different programs at once; multi-tasked regularly yet efficiently. Coordinated a workload between multiple departments regarding billing info, enrollment, formal appeals and determinations. Outreached to members to ensure their insurance needs were met when it came to claims being appropriately processed. Displayed leadership by teaching colleagues proper methods for managing workloads. Generated and helped facilitate Senior Care Options applications for dual eligible members, that lead to thousands of dollars in revenue for the company.