Directly managed the US-based and Philippines based Teams (Total Staff of 55+). Experienced in BPO Management and Call Center Industry. • Established forecasting and performance metrics to monitor progress towards organizational and department goals and objectives.• Provided management coaching and development training, mentoring, and support to jr. management staff to enhance team capabilities and foster processional growth opportunities, promoting a culture of continuous learning, development, and satisfaction, which resulted in high performing teams. • Using Lean expertise and root cause analysis, identified, and led improvement projects that increased productivity and decreased costs. Effectively managed multiple projects and priorities in a fast-paced environment while meeting deadlines.• Collaborated with Provider Relations Team on contracting, new payer set-ups, quality control, contract dissolution, compliance, and compliant resolution.• Implemented and developed operational standards, policies, procedures, and workflows. Analyzed Electronic Medical Record (EMR) systems and leveraged technology and automation, which resulted in improved service levels of by 80%.• Monitor, analyze, and improve operational data to enhance efficiency, identify trends, and ensure accurate reporting, while upholding standard processes for project planning and management.• Collaborated closely with organization management and senior executives to develop long-term strategy plans, measures of goal achievement, and to determine areas of improvement. Driving Continuous Improvement.• Spearheaded the oversight and monitoring of team activities to ensure compliance with legal, regulatory, and reporting standards, resulting in improved adherence and minimized risks.• Developed proposals for lean processing, cost improvements and productivity enhancements, and presentations on Sales and Operations for internal and external audiences.

• Directly supervised the US-based Team (total staff of 15) to perform client-based services including customer contact, PCP Referrals and assisting the Philippines Team as needed to ensure that company/departmental standards and goals were met.• Provided oversight, support and direction to the Philippines based Team (total staff of 80) to perform insurance verifications, prior authorizations, and referrals. Experienced in BPO Management. • Monitored and delegated daily, weekly, monthly, and quarterly workloads, performance metrics against established KPIs.• Trained and performed Quality Audits ensuring accuracy and limited errors of new and existing specialists.• Developed, executed, maintained, and documented departmental processes, procedures, work instructions and workflows.

• Delegation of daily tasks/workload and monitor performance of the Verification of Benefits Team.• Conducted Training and Quality Audits of new and existing Verification of Benefits Specialists.• Verified patient insurance benefits and eligibility with Medicare, Medicaid, private insurance, workers compensation and auto accident companies.• Submitted and monitored prior authorizations, referrals, and single case agreements/letter of agreements.• Provided patients with information on their account including status of new set ups, supply re-order, collecting of co-pay/balances, explanation of benefits and out of pocket costs.• Processed referral requests for patients to achieve timely and accurate determinations, maintaining required turnaround times for referral completion. • Assisted providers and patients with referral status questions, ensuring effective communication and resolution.• Participated in the development and implementation of improvements to the verification of benefits, prior authorization and referral process and workflows, enhancing efficiency and accuracy.

• Verified patient insurance benefits and eligibility with Medicare, Medicaid, private insurance, workers compensation and auto accident companies.• Submitted and monitored prior authorizations, referrals, and single case agreements/letter of agreements. • Provided patients with information on their account including status of new set ups, supply re-order, collecting of co-pays/balances, explanation of benefits and out of pocket costs.

• Verification of patient insurance benefits and eligibility with Medicare, Medicaid, private insurance, workers compensation and auto accident companies.• Submit and monitor prior authorizations and referrals.• Responsible for scheduling of appointments and collecting co-pays for new and existing patients.• Medical billing and collections.

• Verification of patient insurance benefits and eligibility with Medicare, private insurance, workers compensation and auto accident companies.• Submit and monitor prior authorizations, referrals, and single case agreements/letter of agreements.• Provided patients with information on their account including status of new set ups, supply re-order, collecting of co-pays/balances, explanation of benefits and out of pocket costs.

• Accounts receivables responsibilities included: posting payments from Medicare, private insurances and patients to patient accounts.• Medical billing and collections.• Patient collections and statement mailing.

· Provided oversight and support to Team Leader and dental technicians to ensure that dental cases went to completion. · Prepared and monitored project dental cases for multiple dental courses.· Collection of payments for overseas dental accounts and dental courses.· Data entry and billing of dental cases.

· Shipping and receiving of dental cases.· Data entry of dental cases.· Dentist account maintenance includes: set up of new accounts and updates to existing accounts. · Audit of UPS, FedEx and DHL billing.