Manager Customer Service

KELLEE CYPRIAN

**** ********** **** *******, ** 77063 C: 502-***-**** *************@***.***

Professional Summary

High performing, results driven professional with over 10 years of experience of proven abilities in strategic planning, managing projects, improving efficiency of operations, team building, and detailing project information to determine effective processes for operations. Progressive leadership experiences have created a passion for surpassing financial and service objectives via a combination of world class service delivery, lean operating methods, renewed marketing directions, and incentive driven rewards for team achievement. Demonstrated ability to motivate staff to maximize productivity and control costs through the most effective uses of manpower and available resources.

Core Strengths

Project Planning & Development • Multi-Unit Operation Management

Risk Management & Inventory Control • Multimillion Dollar P&L Management

Strategic Planning • Vendor Migration & Sourcing

Facility Management • Team Building & Staff Retention

Professional Experience

CONTINUUM INTEGRATED

BUSINESS OPERATIONS MANAGER, 2014 – PRESENT

HOUSTON, TX

Manage daily operations with clerical and clinical staff in a multi-specialty physician’s clinic

Oversee billing, coding, account follow up, contractual negotiations, credentialing, and claim denials

Facilitate strategic planning process & continuous quality improvement projects

Hire and Train staff on Joint Commission requirements, OSHA, HIPPA, ICD-9&10, and Behavioral Management

Manage financial statements including P&L, Balance, Accounts Receivables using QuickBooks

HR Manager for Physician, Therapists, and Medical Assistants

Manage Care Organization point of contact for contractual negotiations, and credentialing

Monitor and implement procedures guided by Medicaid, Medicare, OSHA, HIPPA

HUMANA INSURANCE

PROCESS/PROJECT MANAGER, 2013-2014

LOUISVILLE, KY

Managed a team of 20 to implement 10 electronic interfaces with HIPAA EDI transactions, fulfillment vendors, and third-party software saving company over 20 million dollars

Designed a 1099 reporting process for tax requirements for the state of Massachusetts members

Provided daily support to operations by partnering with other functional areas to serve as Subject Matter Expert to create efficient procedures for CMS Processing Unit

Lead PMCS project to ensure accurate member disenrollment data was transmitted to CMS

Managed and Implemented policy and procedures for CMS Software Releases by coordinating system logic, data analysis, and Process Implementation

HUMANA, INC

BUSINESS CONSULTANT- ANALYSIS & REPORTING, 2007-2013

LOUISVILLE, KY

Created and Managed a Project Team; focused on process and tool standardization, staff on-boarding and development, candidate evaluation cases, and project reporting and leadership dashboards

Owned client relationships and collaborated with executives to develop implementable solutions specific to the client’s business and strategic IT needs, while also serving as their trusted adviser

Managed both consultant and client teams during large-scale IT system assessments, implementations, and optimizations; included developing strategies and project charters, identifying and mitigating risk, managing project

Consulted with managers to identify and correct usability issues with their Excel-based project management tool, decreasing entry time from 3 minutes to 30 seconds and improving collaboration functionality of SharePoint Tool

Database Cleanup, restructured and documented all program modification of an existing processing system as system was upgraded to Oracle.

HUMANA, INC

MARKET RELATIONS MANAGER, 2004-2007

LOUISVILLE, KY

Lead over 10 projects regarding sales, marketing, customer acquisition, customer relation management

Managed vendor relationships including negotiating and controlling contracts

Assessed market, current trends in market, finding competitors, also giving suggestions for product improvement

Improved operations efficiency by 30% by training and managing client dedicated staff

Reported, tracked, and analyzed all escalated claims and customer service issues

Served as SME for business financial ASO specialist to one of the largest clients

Facilitated and organized Service Center tours for brokers, providers, and customers offices

HUMANA, INC

PROVIDER PAYMENT integrity ANALYST, 1999-2004

LOUISVILLE, KY

Lead audits processes, cultivating the trust among IT and business staff as go to resource for audit questions and recommendation of testing

Prepared risk-based audit plans that address the objectives of each audit area and developing cost effective internal control solutions for identified deficiencies

Served as a consultant to management on internal control and operating issues; analyzing, evaluating and resolving complex internal control issues

Planned, performed, and reported internal audit activity in accordance with CMS Guidelines

Education

Indiana University Southeast Business Management

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