Clerical Supervisor

PATTI STEELE

**** * ***** ****** *****, NE ****4 (h) 402-***-****

Email: ************@***.*** (c) 402-***-****

A goal-oriented customer service professional with 20 years experience. Enthusiastic commitment to customer service as a key driver for supporting company goals. Experience in health insurance including claims, customer service and telephone interviewing. Skilled at building productive relationships with customers at all levels of an organization. A detail-oriented team player with exceptional communication, organizational, multi-tasking and problem solving skills.

PROFESSIONAL EXPERIENCE

World Insurance Company/American Enterprise Group (March 1991-March 2011)

Held a variety of positions over a 20 year period focused on Excellent Customer Service, Quality First and Easy to Do Business with philosophies.

Supervisor, Telephone Interview Department, World Insurance Company/American Enterprise Group. (2005-2011)

Managed a team of 25 to 58 full time and part time employees. Engaged in soliciting information from prospective and current policyholders, including responsibility for developing and administering the employee performance management process, assigning work, and special projects.

• Responsible for development and implementation of a new telephone interview system which included selection of system requirements, testing, building, training and developing policies and procedures for users.

• Over 7 years supervisory experience; directing, assigning, monitoring, mentoring and training staff members.

• Self-starter; able to manage priorities in a fast-paced environment.

• Maintains effective relationships with both internal and external customers, clients, management, professionals and employees in person and via phone. Ability to work with diverse teams and obtain desired goals.

• Experience writing, updating or amending policies and procedures to comply with regulations or guidelines.

• Quality auditing.

• Experience preparing and processing Statistics of individual, team and system results.

• Excellent communication skills; experience working complaints in difficult situations, involving customers to a satisfactory resolution.

• Experience leading informational meetings and training sessions for groups of all sizes.

• Performs all supervisory and leadership tasks including, but not limited to: recruiting, selection, performance management and development, disciplinary processes, employee relations, etc.

• Interacts with staff to maintain effective working relationships by answering questions about work methods and procedures, communicating Company policies, discussing suggestions for maintaining group cohesiveness and collaborating with staff to achieve group goals.

Claims Analyst, Special Projects (January 1997 – December 2004)

Held a variety of claim facing special project roles over 7 year period. Significant depth of experience in handling complex situations.

• Resolved customer/provider issues with detailed auditing and follow through until issues were resolved satisfactory.

• Processed Overpayments/Underpayments for Major Medical, Short-Term and Medicare claims.

• Responsible for training on operations processes as an Analyst for the Special Projects Claims team.

• Administered all state required reports.

• Served as a liaison between World Insurance and the Department of Insurance auditor for all states that World Insurance conducted business in. This required a very strict confidential, detail oriented and accurate disposition with extreme problem solving measures.

Claims Analyst (March 1991 – January 1997)

Analyze claims to determine the company’s liability, make approval or denial decisions on claims in accordance with policy provisions.

• Responsible to review, approve and adjudicate High Risk Claims as well as claims in their contestability period.

• Contract interpretation skills of provider and member contracts to ensure claims are being adjudicated accurately.

• Reviewed medical records for Health History to determine I Pre-existing Conditions existed.

• Worked cross functionally on a variety of insurance contracts each with unique policy provisions.

• Processed Major Medical, Short-Term and Medicare claims.

• Posses an in depth knowledge of state mandates and regulations as it pertains to the contracts I was adjudicating.

Knowledge, Skills and Abilities

Medical Terminology (Dean Vaughn)

HIPPA privacy laws

Office skills include Word, Excel, Power Point, Outlook, Lotus, fax machine, copiers, etc.

Completed a variety of industry related courses

Contact this candidate