Experience

Burgess

• Wine & Spirits
• 1 - 100 Employee

• Client Operations Manager

  • Apr 2022 - Present

• Sr. Business Consultant

  • Jan 2021 - Apr 2022



Cognizant

• Uzbekistan
• Education
• 1 - 100 Employee

• Director - Intelligent Process & Automation

  • Jan 2019 - Jan 2021



TMG Health

• Hospitals and Health Care
• 300 - 400 Employee

• Director - Claims Automation, Pre-Processing & Provider Support

  • Jan 2014 - Jan 2021

   Operational leadership of Provider, Pre-processing and automation department. Leadership over the Robotic Process Automation Team (RPA) $2B in annual transactions processed through RPA Team $5M in operational savings in 2018 $3M in operational savings in 2017 10+ years’ experience in RPA implementations, management and optimization Automation Anywhere and UI Path Experience along with various other RPA tools Spearheaded an 11% increase in automation for claims processing Lead the team that established 600+ robotic processes Developed and instituted an Agile approach to process development and implementation UIPath Certified Enrollment / Claims preprocessing. Provider Support and Management. Provider file/data management. Staff and leadership development. Responsible for all departmental budgeting. Manger of enterprise wide Fraud Waste and Abuse (FWA) department. EDI implementations (837 & 835). EDPS implementation and management Served on the Optum PPS Advisory Board Vendor Management. Process improvement. Reporting and Data Analysis

• Senior Manager - Claims Operations & Support

  • Jul 2002 - Jan 2014

  Manager of Enterprise Wide Fraud Waste and Abuse team. Including: reporting, traige & detection.Medicare and Medicaid Claims Operations (Inventory Mangement, Medicare Processing Rules, CMS Bonus Payment.)Manager of ICD-10 ImplementationManage Claim Business Analysts, Claim Implementation Specialists, Claim Testing Analysts, Fulfillment Analysts, Report Analysts, Sr. Technical Claim Analysts, EDI specialists, EFT specialists.BCBSA ITS Claims Processing (Blue2, Blue Exchange)Sr. Manger or TMG Claims Fraud Waste and Abuse Solution (Medicare)Manage Reporting Department for Claims Reporting (CMS Part C Reporting, HEDIS, Client Reporting)Vendor ManagementCoaches, leads and develops claims support staff