• Super User for Enrollment Blue Core • QA of all MediGap membership using ECS and InSinq.• Putting together QA desk procedures for Blue Core MediGap membership. • Responsible for all reporting and trending for Pre-Enrollment and Enrollment.• Train new and existing QA analysts on new functions.• Receive, report, and distribute Inventory to QA analyst on a daily basis. Keep track of any carryover within each dept.• Submits monthly statistics for each Enrollment processor to Management by the fifth of the month. • Submit monthly statistics for all QDA’s to Management.• Reconcile QA database for both Pre-Enrollment and Enrollment on a monthly basis.• Issue errors to the QDA’s for incomplete or inaccurate documentation in the database.• Assist Compliance in the Model Audit Rule and Service Operations Compliance 1 Audits which are conducted for the business areas performing functions that are considered high risk.• Make sure all desk procedures and policies are up to date, notify Knowledge Management of any changes

Responsible for staff of 9.QA Claims, Customer Service, Enrollment, Appeals & Grievance, Chip for our Medicare departments.Monthly 1:1 of teamResponsible for Reporting, Trending and Coaching. Also assisting Business Areas in recognizing areas of opportunities and ways to create efficiencies.Conduct yearly appraisals.Responsible for growth and development of staff.Complete the hiring and firing process for the team.Work closely with Business Partners for Process Improvement.

• Reviewed all group and member enrollments and changes while exceeding the departmental turnaround time.• Submitted weekly/monthly statistics for each Enrollment processor to Management by the fifth of the month. • Assisted training department with classroom training when processors learned group enrollment.• Developed desk procedures and policies for enrollment and QA. • Created and implemented a manual for the Group Data Form process. • Reconciled QA logs and database on a weekly/monthly basis.• Reconstructed the Access database to meet Enrollment reporting needs

• Processed all group and member activity submitted by Underwriting.• Investigated and resolved all group and member related issues. • Ensured all Enrollment activity assigned was processed timely and accurately. • Processed group and member activity to meet the departmental turnaround time. • Serviced the Large Premier Accounts. • Assisted supervisor with day-to-day activities such as answering telephone inquires and emails from Marketing and Billing areas. • Assisted team lead with the NMIS (report to ensure 10 day turnaround time for group processing)

• Supervised the billing processors. • Trained new employees on Charge Entry, Payment Posting and A/R follow-up. • Balanced the books daily and ran monthly reports to send to clients. • Worked with demanding clients on a daily basis. • Sent patient statements on a monthly basis. Every 90 days transferred outstanding accounts to collections. • Ensured process was in compliance with outside collection agency.• Ran the reports every day. Dealt with our support team C & S on various support issues. • Hired, developed and managed performance of billing staff.