Gary E. Smith Email and Phone Number

Managed team of supervisors and claims processors for Short Term and Long Term Disability, Massachusetts Paid Family Medical Leave and Temporary Disability Income. Created, implemented, managed and maintained tracking and trending reports for claims processing and quality metrics.Through tracking, trending and training opportunities the team's quality scores improved by six percentage points within the first 12 months.Established benchmarks for claims processing with regards to production.Improved customer satisfaction by nine percentage points through tracking, trending and educating the team.

Managed Team of analysts providing accurate configuration of medical plans for members of both Medicare and Medicaid as well as troubleshooting and resolving payment issues for members and providers.Developed, managed, and maintained tracking and trending reports for inventory management and quality metrics.Through training, audit and awareness reduced rework in the department by 22%.Evaluated hiring, firing and promotion requests.Boosted team member productivity by enhancing performance monitoring and instituting motivational approaches.

Managed team of analysts providing accurate configuration of medical plans for members of both Medicare and Medicaid as well as resolving payment issues for members and providers. Created training and processing documents for the team to achieve accurate configuration of all plans.Created guides to assist new hires in issue resolution. Performed times studies to design and implement production standards for issue resolution using level of difficulty as the primary measurement.

Manage a team of analysts and processors that provide expertise in our pricing and adjudication set up which will deliver accurate repricing for our clients allowing Healthe to reflect industry leading savings for workers compensation claims.Also, review of current processes/procedures to identify areas of improvement with our ancillary benefit management department and implement those improvements. Accomplishments include developing a tracking/trending process to reflect daily work loads and daily accomplishments. This tracking/trending tool also assists in identfying issues our clients and vendors are experiencing which aides in seeing overarching issues. I have also developed and implemented a quality audit process that has resulted in enhanced training programs with an increase in overall production and quality output.

Managed a team of Claims Processors, Call Center Representatives, Business Analyst's and EDI Processors dedicated to Group Carriers with a book of business representing 1,100 employers and $70 million dollars in annual premium.Accomplishments include performing time studies and processing trends resulting in increasing average production goals by 23%. Implemented an audit/quality program that reduced errors by 51% in the first two months.

A Six Sigma Black Belt providing continuous process improvements while working as Director of Operations - Integration for TASC. My job responsibilities included working with the sellers of TPA's post signing of the letter of intent, conducting the due diligence to bring the acquisition to closure. My team and I would then work to transition the business to TASC platforms as well as the TASC Service Model. The business represented FSA, HRA, HSA, and Cobra clients. I would also work with the newly acquired staff and our internal HR team to determine the employees we ratained and those that we would displace. I also worked to secure relationships with key transitioning clients and their insurance agents and brokers. Part of my role was also based on the tracking and trending of persistency and what improvements could be implemented to enhance the transition process. Accomplishments included implementing process improvements that lowered our error rate from 11% to 4% during my first year in this position. My team and I were able to successfully drive revenue growth and client persistency following acquisitions that reflected 90% of the overall company growth ($40million to $98 Million) in five years.

I managed a team that administered FSA and HRA plans. The team included customer service representatives, claims processors, relationship managers, compliance experts, and business analysts. I also worked with insurance brokers, BCBSFL sales representatives, and our clients. From my efforts of performing tracking. trending, and continuous process improvements we experience 96% retention of clients. We achieved service deliverables of Average Speed to answer of less than 30 seconds, Abandon Rate less than 5%, and Claims processed within 2 business days of receipt.

As Claims Manager for the workers compensation TPA and Insurance Company, I was part of the original start up team for BCBSFL to develop these departments to administer workers compensation. I did assist in building the managed care network, hiring of staff, administration of claims as well as managing the adjusters and nurse case managers. I also assisted sales representatives with sales calls to acquire new clients. These calls included RFP presentations to the client and their broker. Our TPA business enjoyed 100% retention as well as continuous growth during my tenure in this position.