Call Center or Claims Center Manager
Content
Erik A Wright 3223 Lockwood Dr. Chattanooga, TN 37415 (423) 877-6174 [email protected] Professional Objective Seeking a position within a customer service focused organization where I may ap ply my leadership and management skills experience in claims and call center ope rations. Utilize experience of project management for initiation, planning, and execution of projects that deliver efficient and customer centric servicing nee ds that benefits both customers and the organization. Education University of Tennessee Knoxville December 1989 Production and Operations, Management Bachelor of Science Concentration in Statistics and Project Management Areas of Expertise * Lead large Claims and Customer Service Call centers * Recruitment/Staffing of Management, Customer Service, Research, Business Analy st and Claims * Interviewing experience * Training and development * Hiring and Terminations * Health benefits administration for commercial and government employer groups * Development and execution of budgets at various levels * Operations analysis/trending * Business recovery and sustainability * Procedure and process review and development * Compensation/Payroll * Proficiency with Microsoft Office Suite and web-based reporting tools * Financial reporting for Account Management, Provider Management and Executive levels * Cash flow reports related to overpayment collections * Knowledge of commercial, state, and federal law related to Health Insurance * Negotiation skills with conflict resolution * Traffic analysis designed for Customer Service/Satisfaction * Complex problem solving * Needs assessments * Creative design and Strategic planning * Product management and development * Employee coaching * Internet marketing * Campaign performance tracking Work Experience BlueCross BlueShield of Tennessee (BCBST) - Chattanooga, TN Project Manager September 2010 to Current
* Building key projects for customer needs using today's project management meth odology (initiation, planning, execution, and closure) Senior Manager January 2006 to August 2010 * Lead top ranked provider customer service for payers across the state of Tenne ssee * Most employee engaged operational division throughout the enterprise 2009 * Recognized as a major loss-prevention operation through overpayment recoveries and prevention enterprise-wide * Continually exceeded various goals (BCBST metrics, and provider industry requi rements) for delivery of provider customer service and overpayment recovery/prev ention efforts * Oversaw/sponsored projects related to gained efficiencies with servicing impro vements as related to providers
Erik A Wright * Recognized as a leader for development and maintaining strong partnering relat ionships with Tennessee providers (facility, physician and ancillary providers) and the office staff they utilize * Implemented Provider Interactive Voice Recognition automation and Provider Out reach for Internet services resulting in annual administrative cost reduction of over $600K * Built Financial recovery Application resulting in automating all overpayment r ecovery activities meeting external and internal audit needs (URAC and HEDIS acc reditation) with annual savings of $280K * Significantly improved provider satisfaction over the past 5 years. Going from 83% up to 90% of providers surveyed being satisfied or very satisfied) through improved customer service. Manager, Provider Service Organization Support April 2005 to December 2005 * Designed and built Provider Service Organization to provide a central provider call center focusing on a more efficient provider customer service deliverable based on need and functionality * Developed partnering provider campaigns to recovery provider identified overpa yment's resulting in over $8.5 million annual savings previously unrecognized * Lead support units including: Audit, Financial Recovery, Business Improvement Analysis, Training and Development, staffing and Project Management * Networked with numerous areas of the company (IS, Network Management, Marketin g, all other Operations divisions, Internal Audit, etc.) to ensure effective ser vicing for all providers * Oversaw trending analysis/analytics (root cause format) for process improvemen ts utilizing project management methodologies * Delivered provider presentations for providers on location and at workshops * Designated budget coordinator for division requirements Manager, Regional Benefits Administration July 1998 to March 2005 * Lead claims and customer service for members and providers for all commercial groups based out of the Nashville area including groups such as Vanderbilt Unive rsity Medical Center, Peterbilt Trucking, Paper Allied Chemical Employees Union, and St. Thomas Health Systems * Recognized leader of the Broker Single Point of Contact unit specifically supp
orting brokers, group administrators, and Sales/Account Management * Lead redesign and implementation off enterprise-wide coordination of benefits efforts resulting in annual savings of over $2 million * Delivered key presentations of benefits and new technologies at employee, brok er/group administrator and provider health seminars and workshops * Manager HMO Blue Away From Home Care Program Professional Affiliations HIAA Designation State of Tennessee Health and Life Insurance License 2001-2003 References * Mark Hooton, Esq., Vice President, Legal BCBST 423-535-6504 * Mark Austin, Sr. Vice President, Provider Network Management 423-535-3094 * Connie Seagle, Manager, Member Grievance 423-535-5014 * Jeff Wakefield, Director, Human Resources 423-535-7289 * Pete VanValkinburgh, Director, Health Information 423-535-3330 * David Ellis, Director, Account Management 615-760-8740
* Building key projects for customer needs using today's project management meth odology (initiation, planning, execution, and closure) Senior Manager January 2006 to August 2010 * Lead top ranked provider customer service for payers across the state of Tenne ssee * Most employee engaged operational division throughout the enterprise 2009 * Recognized as a major loss-prevention operation through overpayment recoveries and prevention enterprise-wide * Continually exceeded various goals (BCBST metrics, and provider industry requi rements) for delivery of provider customer service and overpayment recovery/prev ention efforts * Oversaw/sponsored projects related to gained efficiencies with servicing impro vements as related to providers
Erik A Wright * Recognized as a leader for development and maintaining strong partnering relat ionships with Tennessee providers (facility, physician and ancillary providers) and the office staff they utilize * Implemented Provider Interactive Voice Recognition automation and Provider Out reach for Internet services resulting in annual administrative cost reduction of over $600K * Built Financial recovery Application resulting in automating all overpayment r ecovery activities meeting external and internal audit needs (URAC and HEDIS acc reditation) with annual savings of $280K * Significantly improved provider satisfaction over the past 5 years. Going from 83% up to 90% of providers surveyed being satisfied or very satisfied) through improved customer service. Manager, Provider Service Organization Support April 2005 to December 2005 * Designed and built Provider Service Organization to provide a central provider call center focusing on a more efficient provider customer service deliverable based on need and functionality * Developed partnering provider campaigns to recovery provider identified overpa yment's resulting in over $8.5 million annual savings previously unrecognized * Lead support units including: Audit, Financial Recovery, Business Improvement Analysis, Training and Development, staffing and Project Management * Networked with numerous areas of the company (IS, Network Management, Marketin g, all other Operations divisions, Internal Audit, etc.) to ensure effective ser vicing for all providers * Oversaw trending analysis/analytics (root cause format) for process improvemen ts utilizing project management methodologies * Delivered provider presentations for providers on location and at workshops * Designated budget coordinator for division requirements Manager, Regional Benefits Administration July 1998 to March 2005 * Lead claims and customer service for members and providers for all commercial groups based out of the Nashville area including groups such as Vanderbilt Unive rsity Medical Center, Peterbilt Trucking, Paper Allied Chemical Employees Union, and St. Thomas Health Systems * Recognized leader of the Broker Single Point of Contact unit specifically supp
orting brokers, group administrators, and Sales/Account Management * Lead redesign and implementation off enterprise-wide coordination of benefits efforts resulting in annual savings of over $2 million * Delivered key presentations of benefits and new technologies at employee, brok er/group administrator and provider health seminars and workshops * Manager HMO Blue Away From Home Care Program Professional Affiliations HIAA Designation State of Tennessee Health and Life Insurance License 2001-2003 References * Mark Hooton, Esq., Vice President, Legal BCBST 423-535-6504 * Mark Austin, Sr. Vice President, Provider Network Management 423-535-3094 * Connie Seagle, Manager, Member Grievance 423-535-5014 * Jeff Wakefield, Director, Human Resources 423-535-7289 * Pete VanValkinburgh, Director, Health Information 423-535-3330 * David Ellis, Director, Account Management 615-760-8740
