David Mueller Email & Phone Number

Downers Grove, Illinois

• Manage an inbound call center that is comprised of 15 employees that answer a variety of questions that pertains to ancillary insurance (Life/STD/LTD/Vision), Our customers consist of group administrators, agents.
• Business liaison with a change management team, focusing on branding initiatives involving Dearborn and HCSC's five home states.
• Developed implementation process for new customers within the small group market (10-50 employee) which introduces new customers to Dearborn.

Naperville, Illinois

• Managed a team of 15-20 employees (union and non-union) that focused on individual healthcare administration through the retail market. The various areas and teams that I managed included a central file and imaging.
• LSA - Focused on approving system access for all employees and ensuring our department was compliant with HCSC regulations.
• Business SME in the development, coordination, and execution of large projects and system enhancements. Projects included Central File elimination with the IBML, Captiva batch re-design, Siebel Dashboard, Activitii.
• Act as a business liaison for HCSC, developing positive business relationships with various outside vendors and agencies including USPS, UPS, FED EX, AIT, Presort Solutions, and Private Exchanges.
• Analyzed processes, identified deficiencies and developed business plans to improve workflows.
• Previous responsibilities including billing reconciliation through E-procurement ensuring all bills and invoices were paid promptly. Accomplishments Included:

• Primary responsibilities included claims processing in accordance to ICD-9 codes. Additional responsibilities included.
• Conducted investigations on policy holders, looking for misrepresentation of health history based on an application and claims review.
• Reviewed medical records, analyzed health conditions and determined pre-existing conditions in accordance to the submitted application.
• Referred files to underwriting for consideration of rescission or exclusion riders.
• Utilized Blue Source for various procedure code locks while processing claims.
• Trained new employees on the departments guidelines and processes.