Customer Service Manager

TI M O T HY P. AN D ERSON

T *******@*******.*** 240-***-****

***** ********* *******, * *********, MD 21740

D I RECTOR O P E RA T I O NS

OF

EXECUTIVE SUMMARY

Dynamic operations manager with 15 years of achievement leveraging extensive experience in implementing

continuous improvement, business development, and performance enhancement strategies. Innovative operations

expert with proven ability to streamline workflow, implement tactical solutions, and increase efficiency through

aggressive initiatives that deliver profit gains and reductions in operational expenses. Adept at balancing

competing resources across concurrent high-profile projects, while also uncovering opportunities to elevate

p roductivity. Experienced in successfully achieving results in high growth environments.

AREAS O F EXPERT ISE:

Process Engineering – Business Plann ing – Process I mp rovement – Business / Tech A l ignment – Project

M anagement

Change Management – Customer Service – Organ izat ion Opt im izat ion – Cl ient Retent ion – T ra i n i ng &

Development

P R O F ESS I O N A L E X P E R I E N C E

Abarca Health – San Juan, Puerto Rico 2013 to Present

A leading provider of health information technology and clinical solutions to stakeholders in the healthcare industry.

DI R EC TOR O F M E MBER SERV I CES (2013 to Present)

Consulting engagement responsible for design and implementation of the Member Service’s department.

I nclusive of all Call Center and Fulfillment operations and Vendor contracts.

Reduced Call Center expenses by over $120k annually.

Completed multiple vendor contractual agreements

Completed URAC requirements for accreditation submission

Catamaran, formally Catalyst Rx – Rockville, MD 2007 to 2013

A leading provider of pharmacy benefit management services and healthcare information technology solutions.

D I R EC TOR O PERAT IO NS – M E MBER SERV ICES (2010 to 2013)

OF

Responsible for three departments; Eligibility (Client/Member database), Print and Member Materials and

C laims Administration. Directly managed three directors and indirectly managed eight managers, two

supervisors, and 60+ cross-functional FTEs. Managed $14M annual print production and member

communications. Directed $13M annual claims payments and overall P&L for the Claims Division.

Promoted to spearhead all strategic and operational initiatives, including business planning, forecasting and

budgeting for numerous facilities and departments.

Delivered $3.5M in annual savings through print-vendor consolidation efforts through a reduction in

negotiated rates and increased efficiency.

Initiated strategic desktop integration program, uniting claims processing functions with call center

applications creating greater efficiencies and customer satisfaction.

Designed and implemented all policy and procedures to comply with CMS Medicare Part D regulations.

NAT IONAL CLA I MS MANAGER (2007 to 2010)

Coordinated all strategic operations for cross-functional, multi-location claims processing department and call

center. Collaborated with clients to implement continuous process improvement initiatives. Presented project

statuses to executive management, illustrating successful ROIs.

Augmented internal and external communications by implementing case management t racking system.

Increased productivity by 150% by redesigning two IT system enhancements.

T I M O T HY P. AN D ERSON T *******@*******.*** 240-***-****

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Saved $100K annually by decreasing cost per claim by 25%.

Offset 20% annual increase in processing volume with productivity increased that resulted in a net decrease

i n departmental costs.

Ensured centers for Medicare and Medicaid service (CMS) guidelines were executed by creating new

p rocessing procedures.

Nationwide I nsurance Company – P ittsburgh, PA 2005 to 2007

P HYS ICAL D AMAGE C LA I MS M ANAGER

Headed physical-damage losses for the third largest district in PA. Streamlined processes to increase productivity

and workflow efficiency. Managed 12 staff and administrative functions with $12M in annual claims payments

and overall P7L for the claims division. Established, implemented, and managed claims handling strategy,

delivering highly-competitive claims product with quality customer service.

Achieved the No. 1 audit results in the entire company by improving damage appraisal audits through

i ncreased documentation processes.

Recognized as the No. 1 customer service provider in the entire company for two consecutive years.

Progressive I nsurance Company – F L, PA, TN 1997 to 2005

T EA M L EADER ( 2001 2005)

TO

Fast-t rack promotion through a series of increasingly responsible positions based on strong performance in

workforce engineering, process optimization, productivity improvement, and team management. Led four-person

claims unit responsible for reimbursement of $12M annual claims payments. Trained, mentored, and conducted

performance reviews of claims personnel.

Reduced overall repair t imes and minimized average net claims payments, while increasing customer

satisfaction.

Acknowledged as the highest achieving district in the company.

Prior experience at Progressive includes Special Claims Representative and Field Property & Casualty Claims

A djuster.

E D U CA T I O N

Florida State University – Tallahassee, FL

Master of Science, Management, Risk Management, and Insurance

University of South Florida – Tampa, FL

Bachelor of Science, Social Studies Education

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