Sandy Bauer Email & Phone Number

Bismarck Nd

Responsible for the business operations on the Aetna health plans in the states of Nebraska, Iowa, South Dakota and North DakotaFocus is to increase member and provider satisfaction, employee development and retention, and company growth by efficiently delivering competitive services to members and providers through a fully-integrated organization staffed by knowledgeable, customer-focused professionals supported by exemplary technologies and processes. Provides leadership and direction in a Customer Service Center and Claim Processing environment. Maintains oversight of functions including claim payments, customer service, claim rework, implementation, provider relations and plan sponsor operations. Executes strategic and operational plans in support of business segment customer services objectives and initiatives. Responsible for staffing to include hiring and development. Sets business area priorities, allocates resources and develops plans for multiple related teams. Ensures all critical service metrics and operational results are achieved. Manages a team of professional employees and supervisors

Successfully supervised multiple teams responsible for customer service and claims processing functions on multiple systems, benefits and platforms. Exceeded company goals and expectations (average speed of answer, abandonment rate, turn around time, employee satisfaction, employee retention, etc.) Managed claim inventory and phone metrics on a daily basis to include forecasting and scheduling. Mentored new supervisors and developed staff

Held many positions to include Customer Service Representative on multiple systems and platforms within the company, Claims Processor where I processed complex transplant and high dollar claims, did medical review for medical necessity and mentored new processors, Trainer - provided Customer Service Training to new hire classes along with development training to existing staff.