Core Markets CS Team Manager

• Nov 2022 - Present

Team Manager with a focus on health and social care, collaborating with all levels of Customer Success Leadership to continuously build and improve a programs-based strategy and team to manage customer relationships by segment and persona. Using an operational and strategic mindset, with a heavy focus on the customer and team-oriented relationships, thriving in a high-growth and fast-paced company environment.

Associate Customer Success Manager

• Sep 2021 - Nov 2022

Sales Service Coordinator- Government Programs

• May 2019 - Sep 2021

1. Responding to both written and oral inquiries from the agents/accounts, researching and problem solving of service issues with appropriate departments. 2. Performs group enrollment presentations and represents Moda at benefit and wellness fairs. 3. Conduct review of performance guarantees, monthly, quarterly, and annually, gathering the information from departments internally, and ensuring delivery to agent/group in appropriate timeframe. 4. Oversee analysis and identification of root causes of complex service issues for agent and customers; directs dedicated functional experts (billing, customer service, claims, etc.) on corrective action steps to ensure end to end resolution of the issue. 5. Coordinate enrollment meetings, design and development of literature, and coordination of new ID cards and brochures. 6. Coordinate the designing and developing non-standard literature, enrollment applications, member guides, Q & A’s and other special marketing materials. 7. Service calls to accounts explain program value and troubleshooting challenges specific to individual client’s needs. Show less

Dental Case Manager

• Sep 2017 - May 2019

1. Dental Case Management. Working Special Needs Cases, DHS Foster Children, Sealant Metrics and Dental Outreach based on co-morbid conditions. 2. Maintains a current list of OHP providers by county. Consult with dental professional relations regarding provider participation.3. Maintain a comprehensive knowledge of all OHP benefits, limitations, frequencies and exclusions.4. Review all OHP complaints and appeals as entered in Facets by customer service representatives prior to review by appeals coordinator to ensure all required information was entered appropriately.5. Provide comprehensive OHP training for new customer service representatives. Provide ongoing training to customer service department as needed. This includes preparation of curriculum and reference materials, and conducting the training.6. Review and revise all dental customer service OHP provider and member letters to ensure information is current and meets DMAP requirements.7. Primary subject matter expert for DCO/CCO integration. Prepare a training program for dental customer service representatives, leads, and supervisors on all aspects of Moda OHP DCO/CCO integration. 8. Update existing and prepare new Medicaid UPM pages and CIS notes as needed.9. Create and update resource materials as needed.10. Attend quarterly DQIC meeting. Prepare all dental customer service reports for this meeting and present reports to the committee. Ability to travel and attend OHP regional meetings annually.11. Participate in the annual OHP provider and member handbook review 12. Assist customer service representatives with questions14. Audit OHP customer service calls as requested by supervisor15. Interact with dental professional relations and quality specialist as needed for provider access, interpretation of OARs and other OHP related issues. Show less

Office Manager

• Nov 2016 - Oct 2017

1. Create, establish and manage internal office protocols and procedures to ensure office efficiency 2. Hire and train new office staff to respond to patients’ needs and manage billing systems 3. Greet and serve all patients as they arrive (or direct other staff to do same) 4. Maintain the dental clinic’s budget, general ledger and accounting systems 5. Motivate office personnel to serve patients 6. Oversee the processing of insurance and secondary insurance claims 7. Assist patients with applying for credit and other financial assistance 8. Provide the Dentist with administrative and practical support when asked 9. Clinical Follow Up with any claims issues 10. Running reports based on accounts payable 11. Organizing and running monthly staff meetings 12. Coordinating and running morning huddles going over schedule, financial goals for the day 13. Running a BAM bonus structure for staff 14. Motivating staff and maintaining a positive, goal oriented work place. 15. Community Outreach, speaking at grammar schools & community events. Show less

Agent Coordinator

• Mar 2016 - Oct 2016

• Appointing, affiliating and verifying licensure of all commissioned brokers in OR, UT, WA, ID & MT • Monitoring of Errors and Omissions coverage for all appointed brokers • Assigning Agents of Record for groups/individual members • Updating/Editing process documentation for all department processes • Email communication with brokers regarding commissions, licensing • Salesforce knowledge • Appointing, affiliating and verifying licensure of all commissioned brokers in OR, UT, WA, ID & MT • Monitoring of Errors and Omissions coverage for all appointed brokers • Assigning Agents of Record for groups/individual members • Updating/Editing process documentation for all department processes • Email communication with brokers regarding commissions, licensing • Salesforce knowledge

Business Implementation Coordinator

• Sep 2014 - Mar 2016

• Completing Mid-size and Small Group set up in a high pressure, high performance setting• Thorough knowledge of Facets & Excel• Writing UPMs and Training Manuals for 51+ Group Set Up▪ Editing UPMs on Alaska Group Set Up, Enrollment, Enterprise Benefit Tracker & Employer Online Services Set Up• Point Person for AIMS group setup, audit and changes• Group project management, such as organizing UPM documentation and training new staff

Web Administrator

• Jan 2014 - Sep 2014

• Assisting members, group administrators and providers with password resets• Guiding members and providers through web related errors, troubleshooting issues experienced by users over the phone and via e-mail• Navigating account set ups for EBT, EOS & MyModa• Activating new accounts for EBT and EOS, based on contracts received• Troubleshooting and tracking web related errors• Compiling detailed reports of "bugs" or trouble tickets within our web applications for report to IS• Managing several inboxes of email correspondence, including Medical, Dental, EOS, EBT & MyModa Show less

Customer Service Representative

• Jul 2013 - Jan 2014

• Assisting members and providers understand benefits, claims and contracts• Handling a high level of call volume on a daily basis• Excellent statistics, “Exceeding expectations” in every aspect• Working with claims, contracts and specific benefit wording in order to explain claims, benefits and procedures• Strong familiarity with cpt, icd 10 and icd 9 coding

Office Manager

• Jun 2011 - Jun 2013

• All insurance billing • Medical dictation work, including coding knowledge for alternative medicine • Light Clinical Duties, ie; removal of acupuncture needles, preparation for hot cupping, moxibustion and massage work • Managing office website, zenspacehealing.com • Compiling information for medical necessity reviews and working closely with referral departments for HMO plans • Working closely with MVA & PIP benefits in the State of Oregon • Training new office staff • Management of entire facility, including any miscellaneous responsibilities, and the management of 2 receptionists, 3 massage therapists and 6 acupuncturists. Show less

Office Manager

• Jun 2011 - Jun 2013

• All insurance billing, working primarily with Medicare patients • Medical dictation work • Light clinical work, included taking blood pressure and conducting electrocardiograms • Medicare & Medicaid prior authorizations and referrals • Continuous communication with accounting and hospital staff • Payroll for entire office staff • Training office staff • Project management, including the credentialing of the providers, software management, and conversion to an electronic claims and medical records system Show less

Lead Preschool Teacher

• Aug 2009 - May 2011

• Head teacher for preschool age children, 3 - 5, 20 students per class • Daily composition of lesson plans • Monthly configuration of education goals for each student, as well as the goals of the classroom as a whole • Educating children in not only math, science and reading, but in social activities and behavior as well • Specializing in children with attention deficit disorder & sensory processing disorder • Scheduling and team management for teacher’s assistants and fellow teachers Show less