•Oversaw daily activities of the Claims Customer Service Department and supervised a team of 10-15 customer service representatives who supported inbound lines and managed offline task related to new and processed claims•Researched, troubleshot and resolved difficult claims, escalated calls and appeals•Distributed and managed offline work processes of 1500-2000 claims daily•Facilitated meetings and conducted training and employee on boarding sessions•Demonstrated project management skills forecasting work distributions for the Claims Customer service Department and reporting projected work weekly in staff meetings•Engaged and collaborated with staff to identify and address training needs•Tracked agent productivity and performance using Microsoft Excel spreadsheets and access databases•Conducted interviews of potential candidates; made recommendations for hire•Worked with leadership to develop incentive programs, track for successful implementation and overall success of program•Successfully engaged a compartmentalized metrics assessment targeting concepts such as active listening, process adherence and member experience. The result was a sustained 30% decrease in the average handle time of inbound consumer escalations relative to newly and previously adjudicated medical claims.

•Directed and monitored activities of 15-20 staff to ensure productivity and goals were met•Led by example with strong work ethic, supportive mentoring and through handling escalated situations in a professional manner•Oversaw administrative issues (associate level, disciplinary actions, timekeeping and scheduling). Ensured production effectiveness by monitoring reports, Represented department with efforts to promote relationships, improve processes and secure goals.•Assisted the Veteran Administration in all aspects of 3,000+ Veterans throughout the US and Puerto Rico with scheduling of appointments, cancellations and/or triage with local VA hospitals and civilian providers that were suitable for veterans' health needs.

•Assisted veterans in scheduling, cancellations promoting relationships, improving processes and securing goals.•Validated veteran and medical provider demographic information including selection of provider by specialty.•Determined veteran eligibility to receive health care benefits under the program by status and authorization path. Processed veteran case files in authorization system and communicated via written correspondence to the Veterans Administration when needed