Kristopher Dunlavey Email & Phone Number

Rochester, New York, United States

Responsible for overseeing and coordinating project tasks related to Internal Product Setup and Product Filing procedures across the organization. Acts as the go-to expert on developing new plans/groups or enhancing existing products, possessing a deep understanding of operational requirements, plan membership, and regulatory compliance. Collaborates through established channels to execute tasks aimed at product implementation and enhancement. Engages with internal departments to support both internal and external initiatives. Plays a key role in maintaining comprehensive product plan and benefit data across the enterprise, ensuring accurate distribution to relevant teams, channels, and systems. Leads meetings for Product Portfolio Filings, guiding the process from planning to execution. Also brings experience in Product filings and Case installs, particularly in ASO/TPA, Medicare, and Commercial health care administration. Proficient in facilitating meetings and possesses a solid grasp of essential ASO operations.

Rochester, New York, United States

Led a team of 23 customer service representatives responsible for investigating and resolving complicatedcustomer (member / physician) inquiries related to benefits, claims, eligibility, referrals, appeals, etc.Managed the daily operations and performance of the Customer Care Center while meeting and exceedingkey departmental performance metrics (timeliness, quality, and accuracy).Adapted to challenging circumstances while ensuring an elevated customer service experience andmotivated team members to exceed individual and team goals.Delivered process improvements with out of the box thinking and change management.Participated in ongoing improvement of the Customer Care Center’s quality programs.Solicited feedback on programs with the goal of continually improving the quality of customer service.Developed staff by training, performance managing, and coaching - including areas that requiredopportunities for improvement.Recruited, assessed, and hired Customer Care staff to build and maintain a high performing team.

Rochester, Ny

Stayed up to date on all aspects of Medicare operations including understanding Medicare Chapter 2Guidance, reporting, processing applications, and implementing a daily workflow for the enrollment team.Streamlined daily communication for meetings (both in person and virtual), Facets, Macess, and MarketProminence.Led collaboration across departments to ensure member satisfaction, minimize disruptions, and encourage apositive and accountable work culture.Accurately reviewed, coded, and processed a variety of member service requests including enrollments,terminations, retroactive submissions, and clarifying questions based on guidelines from CMS.Interviewed, hired, and trained a team of consultants during Medicare’s open enrollment period.Managed consultant’s performance for quality control and timely processing metrics set by CMSMentored, counseled, and guided the team of consultants resulting in retention and overall satisfaction withinthe department.Established and maintained audit controls to ensure correct processes and procedures were upheld to meetestablished Medicare guidelines.

Rochester, New York Area

Spoke with potential clients and gave detailed information about the features and advantages of policies offered. Calmly and successfully resolved customer disputes and played a valuable role in customer retention and improved relationships. Processed newly enrolled Medicare clients while always delivering excellent customer service. Handled a variety of insurance types, including HMO, POS, PPO, Medicare, and Medicaid. Addressed subscriber inquiries in all areas including: enrollment, claims processing issues, and benefit interpretation while maintaining confidentiality. Demonstrated accountability and follow-through in a fast paced call-center atmosphere.

High School

Education record