Michael D. Coates Email & Phone Number

As a Vistage member, I am committed to elevating my company and my community. Vistage is the world’s largest CEO peer advisory and executive coaching organization and has been helping business leaders make better decisions that get better results since 1957

Torrance, Ca, Us

Torrance, Ca, Us

Torrance, Ca, Us

Torrance, Ca, Us

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:• Supervise and manage staff in claims processing, ID card creation, appeals, vendor management, reinsurance, audit, eligibility and provider networks and contracts; providing leadership, training, guidance, and mentoring to maintain performance metrics in quality and productivity.• Identify appropriate allocation of work to internal and external resources, create and maintain resources budget to match EBTPA budget and performance goals.• Manage key vendor relationships that support customer service, claims production, and quality.• Lead, Develop and maintain audit guidelines for quality and performance for both staff and outside vendors.• Identify and implement process improvements in conjunction with internal and external resources by identifying, defining, documenting, testing and training enhancements to existing EB TPA processes and procedures.• Develop and maintain relationships with key clients, internal and external stakeholders and vendors.

Burbank, Ca, Us

I am responsible for implementation and on-going management of the ACA Solution for Cast and Crew, Entertainment Services. My responsibilities include the creation, administration and compliance of the Affordable Care Act offering. I am an ACA subject matter expert and lead the organization through the process of implementing a solution to this complex new regulation and developing value-added products and services to our production clients including major studios and independent production companies. I lead a cross functional team to ensure the implementation is properly executed and policies and procedures implemented to effectively and efficiently manage the on-going delivery of the related products and services. Additional responsibilities include:• Evaluate, recommend and execute on new business opportunities with respect to products and services in response to ACA• Create sales and marketing collateral and present offering to clients• Management of Multi-employer Welfare Arrangement (MEWA). • Create business plans in support of all new products and services including all aspects of its implementation, design, marketing, pricing and support• Manage responses to Request for Proposals (RFPs) with respect to ACA related products and services

Irvine, Ca, Us

Manage the claims being processed within the MEWA, ERISA, and California Department of Insurance standards as they apply. Responsible for both timeliness of production and quality performance of claims. Monitor personnel activity with regard to hiring, training/development and evaluation of staff performance. Interview, hire, and manage termination process, when applicable. Revise procedures to improve efficiency of work flow. Monitor large case management files with UR.Help prepare claims reports for the Trustees and management, as needed. Ensure timely responses to customer inquiries and requests for information. Monitor reinsurance process to ensure timely filings occur and year-end process meets client needs. Manage a customer service team to ensure average ASA is met within Group expectations.

Irvine, Ca, Us

• Demonstrates excellent knowledge of Health Benefits Exchange coverage, eligibility requirements and the application and enrollment processes.• Develops call center operational strategies by conducting needs assessments, performance reviews, capacity planning, and costs/benefit analysis• Defines CRM user requirements, establishes technical specifications, production, productivity, quality, and call center metrics. Contributes information and analysis to organizational strategic plans and reviews• Develops call center systems by developing customer interaction and voice response systems, and voice networks; assisting in the design of user interfaces; developing and executing user acceptance test plans and planning and controlling implementations. • Accomplishes call center human resource objectives by recruiting, selecting, orienting, training, assigning, coaching, counseling, and disciplining employees.• Prepares call center performance reports by collecting, analyzing and summarizing data and trends.• Provides leadership experience in a collaborative and productive team environment.

Indianapolis, Indiana, Us

• Managed staff of 300, preparing work schedules, assigning specific duties, planned budgets, reviewed expenses and cut costs • Developed and implemented strategic plans that increased efficiency and effectiveness• Monitored inventory and found ways to increase profitability • Established and implemented departmental policies, goals, objectives, and procedures, conferring with board members, organization officials, and staff members as necessary• Demonstrated a clear knowledge of laws, regulations and guidelines related to healthcare management• Determined staffing requirements, interviewed, hired and trained new employees

Indianapolis, Indiana, Us

• Ensured incoming calls were answered in a timely and effective manner• Interceded on complex issues to resolve them as quickly as possible• Screened, hired, monitored and terminated call center representatives• Monitored and reviewed daily metrics reports to ensure unit and department goals were achieved. i.e. Service Level, Abandonment Rate, First Call Resolution and Performance Guarantees• Reviewed representatives performance during scheduled 1:1’s. Metrics reviewed were AHT (Average Handle Time: Talk Time, Hold Time, Call Wrap Up), Attendance, Call Quality, areas of strength and areas of improvement• Partnered with Work Force Management Department to effectively schedule representative to meet the call demand.• Fairly and objectivly evaluated representative performance based on established policies and procedures• Motivated representatives with incentive programs that increased quality as well as quantity • Implemented workflow improvements that increased call center productivity and customer satisfaction

Indianapolis, Indiana, Us

• Planned, developed and conducted performance development and learning solutions for Claims and Customer Service Department staff• Utilized a beginning to moderate understanding of adult learning principles and training concepts to engage learners • Used effective writing skills to write and maintain training• Conducted technical claims and customer service training for multiple products and states• Collected, recorded, and reported learning activities and employee progress• Managed the learning environment for classroom setup, systems setup, course materials, media and on-line learning • Provided feedback to management on policy and procedure improvements and assessed learning need.• Designed and maintains course curriculum and skill checks, while evaluation effectiveness of learning program and incorporated enhancements

Indianapolis, Indiana, Us