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Results-driven Operations Manager with extensive experience leading high-volume service delivery, improving cross-functional workflows, and managing relationships with internal teams, external customers, and vendors. Skilled at analyzing performance data to meet or exceed departmental metrics, service-level agreements (SLAs), and data-integrity standards. Maintained 100% compliance by completing annual certifications in System Security, Ethics, and Fraud Prevention.

Analytical and detail-oriented, with the ability to use secure database systems and regulatory guidelines to reduce risk, protect confidential information, and ensure accurate transactional processing.

Operations Manager at CareFirst BCBS (2011-01 – 2022-12)

Effectively managed day to day operations of supervisors, claims processors, claims adjusters, analysts, coordination of benefits analysts and clerks in Claims Operations and Coordination of Benefits Department. Responsible for development and oversight of daily operating procedures. Compiled data for performance metrics.

• Effectively managed all staff in meeting/exceeding all Departmental objectives; Ensured all staff were properly trained and coached for success
• Took necessary action to ensure associates met the requirements of production, timeliness, efficiency and accuracy; Tracked statistical data for improvement opportunities; Created associate opportunities for growth and advancement; partnered with the Training and Audit departments
• Effectively fostered teamwork and communication with Company's support departments to ensure departmental goals were met and fostered positive customer satisfaction and experience; Supported department's implementation of projects and mandates as well as corporate initiatives
• Effectively supported various departments to ensure the overall success of the company; participated in various workgroups representing departmental needs and expectations
• Effectively managed budget and projections, as well as staff forecast and planning
• Worked directly with external support vendors to maximize COB savings; partnered with Legal to manage vendors contracts; developed standard operation procedures and guidelines

Operations Supervisor at CareFirst BCBS (1998-01 – 2011-12)

Created and promoted a team environment for Claims Operations, Customer Service, Enrollment and Billing that supported and facilitated the delivery of superior customer service to both internal and external clients.

• Effectively managed Performance Guarantee Groups to ensure that all agreed upon timeliness and accuracy goals were met monthly/quarterly/yearly
• Coached and counseled towards success in meeting of departmental and succession goals
• Reviewed departmental reports for potential trends, issues, corrections and training needs
• Analyzed current policies and operating procedures for recommendations for process redesign improvement
• Participated with various projects in accordance with company, divisional and departmental goals
• Completed annual performance assessments for associates

Quality Assurance Coordinator at Psych Systems of Bethesda (1996-01 – 1998-12)

Maintained supervisory oversight of Financial Counselors for partial hospitalization in order to ensure the accuracy and efficiency of documents and forms utilized and submitted to the Corporate Business Office.

• Oversaw paper flow process between financial counselors and the Corporate Business Office
• Developed and implemented quality control procedures/monitoring tools
• Oriented and provided on-going training and education for financial counselors
• Completed electronic billing for Medicare/Medicaid for the Corporate Business Office

Financial Counselor at Psych Systems of Bethesda (1994-01 – 1996-12)

Responsible for financial assessment of patients for Partial Hospitalization to accurately determine third party and self-pay liability.

• Identified funding sources
• Determined, documented and conveyed eligibility and level of benefits
• Secured financing on self-pay liability (i.e. loan program or in-house written payment agreement)
• Negotiated payment arrangements
• Collected deposits/advance payment
• Performed third party and self-pay follow-up as required
• Revised/streamlined the admission paperwork process
• Partnered with Marketing and the Medical Team to improve the admission process and ratio
• Experienced a 99.9% admission rate increase due to creative financial counseling

Youth Leader/Teacher and Adult Teacher at Faith Based Institution (2010-01 – 2020-12)

• Taught Youth and Adult Classes from pre-selected lesson plans
• Oversaw weekly Lesson Plan for children ages 4 – 12
• Distributed weekly Lesson Plan to teachers
• Assisted with scheduling and assigning of teachers
• Organized Community outreach endeavors

Library Technician at Library of Congress

Significant experience in the Stacks and Card Catalog Unit.

Bachelor of Science Degree