Customer Service Manager
Resume:
REBECCA DODSON
York, SC *****
Tel: 704-***-****
Email: *****.******@*******.***
Summary
Skilled in multi-tasking and maintaining focus on the long term goals
established by the organization. Dedicated to working efficiently and
accurately under pressure while maintaining a positive outlook regarding
the Company's established values and practices.
Career History
TRANSAMERICA REINSURANCE
Level II International Operations Analyst August 2009-
present
Responsibilities include reviewing and posting monthly/quarterly premium
statements for multiple international clients (Korea, Japan, Latin
American, etc) which adds a complexity to the general ledger posting
process due to the multiple currency exchange rates and "home grown"
systems which enable this workflow to exist. This process also includes
communicating with multiple regions, time zones, and cultures to ensure
accuracy in the reporting of premium data and claims in compliance with the
treaty provisions. Current key goals include transitioning existing paper
reporting to an electronic data format that can utilized to assist with the
experience studies and enable the overall statement process to be more
effective. This includes coordinating the assistance of data management and
IT teams to ensure all results are met for value of new business.
Claims Analyst Team Lead February 2008 - August 2008
Assisted Manager with day to day operational functions to ensure that all
results were met and maintained. Trained as a back-up to the Manager to
act in her absence regarding reports. Facilitated multiple in house
training (Specifically: A Lunch and Learn on selecting the correct Causes
of Death and WIP release training which included a step-by-step guide to
processing claims.) Continued collecting SOX documents for the team, team
audits, processing complex claims, and supporting the analysts as needed.
Senior Claims Analyst July 2006 -February 2008
Continued analyzing/processing reinsured life claims with more focus on the
more complex clients. Began collecting SOX documents for the team, team
audits, and supporting other analysts when their workload was heavy or they
were out of the office. Facilitated Beyond the Basics for Claims.
Claims Analyst April 2006 - July 2006
Analyze/process reinsured life claims with accuracy and timeliness. The
policies are reinsured and retro ceded through multiple companies both in
the US and across multiply continents.
MUTUAL OF OMAHA, Gastonia, NC 2003 - 2005
Technical Unit Claims Manager
Supervised a team of 22 Claims Analyst/Specialists and the office's
trainer. The analysts and specialist handled appeals, adjustments,
preauthorizations, returned drafts, refunds, and worked directly with new
examiner trainees. Monitored results through monthly MBO's (Managed
Business Objectives). The office trainer was responsible for all new hire
training classes in addition to "in house" refresher trainings as
determined by quality results. The responsibilities of the Technical Unit
Claims Supervisor also included completing payroll, daily work
distribution, inventory management, coordinating support when necessary
with Sister offices in South Dakota and Oklahoma, bi-annual and annual
appraisals, continual staffing analysis, and maintaining Gallup survey
results within the 50th percentile.
Responsible for revising existing technical production standards which
resulted in a staffing reduction saving approximately $150,000 in
salary. This project began in July, 2005 and the new standards were
implemented in October, 2005.
MUTUAL OF OMAHA, Gastonia, NC 1996 - 2003
Production Claims Unit Supervisor
Supervised a team of 22 Claims Examiners ranging in experience from new
hires to seasoned associates. These examiners were responsible for the
accurate and timely processing of medical health claims which were
monitored through monthly MBO's. The responsibilities of this position
also included completing payroll, daily work distribution, inventory
management, dictating and delivering bi-annual and annual appraisals,
continual staffing analysis, and maintaining Gallup survey results within
the 50th percentile.
In January, 2003, the Company transitioned to a Trizetto computer
system (Facets) which resulted in a reduction of each team's size by
approximately 5 examiners. As the first team in the office to process
claims on this system, accuracy and timely handling of claims did not
suffer. In addition, interaction between my team and the IS (system)
team was critical to ensure that the OBRA (Omnibus Budget
Reconciliation Act of 1993) Law was applied appropriately to the
applicable claims.
MUTUAL OF OMAHA, Gastonia, NC 1995 - 1996
Technical Claims Analyst
Responsibilities included reviewing first level appeals, preauthorization
requests, loss control reviews, claim adjustments, returned drafts,
refunds, and working directly with the newest examiners.
MUTUAL OF OMAHA, Gastonia, NC 1994 - 1995
Customer Service Representative
Responsibilities included answering calls from members and providers
regarding benefits; eligibility; specific claim related inquiries; and
initiating preauthorization requests, appeals, and claims adjustments.
MUTUAL OF OMAHA, Gastonia, NC 1993 - 1994
Junior Claims Examiner
Responsibilities included accurately and timely processing paper medical
and hospital claims submitted via HICFA 1500 and UB92 forms.
Education
Gaston College, Registered Nursing Program (9 credit hours from completion)
Professional Development
Transamerica's Team Leader Development Program (November 2007)
Dean Vaughan's Medical Terminology
Quality Management (QWG) certification course
Service Plus (seven week Customer Service certification course)
Interact
Achieve Global courses: The Service Difference (TSD); Your Role in
Quality; Managing Extraordinary Service; Moving the Organization Forward:
Defining Your Team's Contribution, Resolving Conflicts within Your Team,
Gaining Commitment to Preset Goals. The Principles of Genuine Leadership
Manager's Version: Giving Recognition, Handling Emotions Under Pressure,
Correcting Performance Problems, Developing Others, Providing Constructive
Feedback, Proactive Listening.
E-learning and internal courses provided by Transamerica and Mutual of
Omaha: Coordination of Benefits, quarterly fraud awareness, managing
without Interference, Managing within the Law, annual Harassment
Prevention, Behavioral Interviewing, Your Role in Quality, DISC profile.
Seminars: Franklin Covey's Focus
Special Skills: Microsoft Office (excel, word, power point) and Facets
(Trizetto developed claims paying system). Transamerica created and
maintained systems include: RIAS (general ledger system), CARES (claims
paying system), PODS (system used to "house" premium and eligibility
information), TRIAD (foreign currency ledger), LiveLink and Keyfile
(electronic scanning systems used to store treaties-policies and data).
Contact this candidate