Henderson, NV 89011
To obtain a position leading a team of employees in an operational area with an eye toward performance improvement and cost savings.
1991 – 2017 Group Health Inc. / EmblemHealth New York, NY
Manager – Claims Support 2000 -- 2017
Supervise staff of management and Union employees in day-to-day activities within the Claims Support department responsible for Shared Services operations.
Coordinate with vendor on outsourcing project that saves $15 million annually for the company by improving efficiency and reducing staff.
Interact daily with all levels of corporate management across all lines of business within EmblemHealth. Departments include: OCR, Document Management, IT, Claims, Grievance and Appeals, Customer Service, and Correspondence.
Daily responsibilities include analysis of operations to identify processes that require modification and improvement.
Developed and maintain all departmental reports that track inventory, production and quality for UDC, Scanning, and OCR.
Created reports that monitor departmental cycle times.
Automated report process to pull data from multiple sources in order to remove manual processing, improve quality and reduce time needed to complete.
Implemented the Correspondence Claims Importer and Certified Barcode Database within UDC to reduce paper consumption, eliminate manual processing, and improve departmental cycle times.
Continue to implement initiatives that increase UDC quality and production, while reducing overall departmental costs.
Prior experience within GHI/EmblemHealth:
-Manager, OCR/Document Management – 15 years supervising staff with as many as 9 Management employees and over 100 Union employees. Process improvements and technical enhancements reduced staff and improved quality that created substantial savings for the company.
-Supervisor, Coordination of Benefits/Provider Directory – Three years supervising staff of 9 Union employees to maintain COB and Provider mainframe records. Procedural improvements reduced staffing by 60%.
-Senior Analyst, Coordination of Benefits – One year coordinating corporate initiative to recover overpayments on claims due to record COB changes. Research into claims histories resulted in receiving refunds of over $1.25 million.
-Claims Approver – Experience within the following departments: Claims Entry, Exceptions, Adjustments, and COB/Provider Directory.
2014 – 2017 Apple Metro, Inc Jamaica, NY
Interact with customers and other employees to ensure the highest quality guest experience for all. Engage with management to maintain a fluid and consistent work environment.
2005 – 2013 Madison Square Garden New York, NY
Direct customer interaction includes serving alcohol and monitoring consumption by the customers. High speed, high volume environment that emphasizes extreme customer service while maintaining high sales volume. Events commonly result in $3,000 in sales within a few hours.
2001 – 2004 Manhattan Center New York, NY
Bartender / Bar Manager
Supervise bar set-up before event, bar sales and customer service during event, and break down of bar after event.
Each bar station is high volume, with up to four bartenders generating $12,000 in sales in as little few as four hours.
1989 Peoria Chiefs Baseball Club Peoria, IL
Message Center Operator 1989
Work in game day operations, interacting with team advertisers and management to help entertain fans in attendance.
1990 – 1992 Nassau Community College Garden City, NY
Associates Degree in Communication; with courses in Business, Management, Computers, Statistics and other general education courses.
2000 The American Bartenders School New York, NY
Bartending and Serving Alcohol with Care
1988 South Side High School Rockville Centre, NY
New York State Regents Diploma