Currently I am assisting the Receivership team with our former members benefit, claim, accums, and inquiries in filing a Proof of Claim. I handle all employee benefit and claim escalations, and audit the incoming calls and emails to the Client Advocate team. I handle all payroll activity for my staff.Strategic planning in developing and overseeing the Client Advocate team. Investigates member/broker /employee benefits and escalations regarding outstanding claims, the member experience, and quality of care. Implements improvements among the Evergreen Health team to improve the member’s experience and health. 98% success rate• Developed scripts, training materials, policy and procedures, workflow strategies for member services to deliver excellent customer service. Participated in several Steering Committees.• Developed Q/A of member and broker calls, and developed corrective action in place for call standards.• Organized and managed resources to take special projects from the initial concept and design through successful completion for the Chief Officer Team.

Developed, organized and processed the Administrative Appeals policy and procedures. Developed the claims appeal and claim business rules working with the Evergreen Health Compliance Officers to adjudicate administrative appeals. Mentored and trained new hires for administrative appeals, interns, and administrative staff associated with this process.