Hi, I’m
Melissa Massengale
Galt
Summary
To obtain a role utilizing creative solutioning skills to enhance the customer experience
Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Overview
22
years of professional experience
Work History
VSP
Workflow Coordinator
12.2021 - Current
Job overview
- Triage and respond to email to case requests within 24-hour SLA.
- Act as first point of contact for email/cases, voicemail responses, and escalations from Internal/External business partners.
- Coordinate and/or create cases for all items received that need to be addressed by a team member.
- Follow up on requests and commitments and keep case/task comments up to date.
- Review and approve retro membership updates within allowed retro guidelines and dollar amounts.
VSP
Customer Support I
12.2021 - 03.2022
Job overview
- Handle incoming Provider calls; issue authorizations, negate and adjust claims, coordination of benefits.
Blue Shield of California
Small/Large Group Member Processing & Clerical Team Lead
11.2003 - 12.2021
Job overview
- Subject matter expert on underwriting, state and federal guidelines for health care in small business, ACA, Covered California, HIPPA and privacy laws, Federal Cobra and Cal Cobra guidelines.
- Managed daily inventory across 10 – 15 processors ensuring cycle time and quality goals met.
- Performed monthly 1:1 sessions with team members for feedback, goal and growth opportunities.
- Responsible for promoting and contributing to team and company engagement priorities and Great Place to Work goals; applied Growth Mindset
- Reviewed quality goals and scores to identify trends and areas of clarification or improvement in processing guidelines and desk level procedures.
- Worked closely with analysts, operations specialists, and other internal business partners to streamline and identify process improvements.
- Document owner for all team desk level procedures content.
- Focus on identifying outsourcing opportunities to offshore vendors.
- Point of contact for customer service reps, sales, account managers and other internal staff for access to care issues, priority requests and general processing and guideline questions.
- Auditor member level maintenance and new group install processing.
- Designated processor for top rated Broker community.
- Coached team members in techniques necessary to complete job tasks.
- Processed fallout from specialized electronic 834 file clients and reports.
- Helped meet changing demands by recommending improvements to business systems or procedures.
- Group Maintenance Processing and New Group Installation.
- Installed new business groups and members, processed group level open enrollment and maintenance changes.
- Auditor for group level maintenance and new group install processing.
- Small Group Renewal Letter generation.
- Contract Letter Processing and generation.
Education
San Joaquin Delta College
Associate of Science from Business
01.2020
Skills
- Remote team management
- Workflow management tools
- Workload balancing
- Team development
- Production deadline monitoring
- Quality standard management
- Efficiency improvement
- Quality monitoring
- Vendor relationship management
- Meeting facilitation
Availability
See my work availability
Not Available
Available
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
swipe to browse
Accomplishments
- Supervised team of 15 staff members.
- Achieved offshore vendor outsourcing by introducing Thunderhead for Cal-COBRA letter generation.
Work Preference
Work Type
Full TimeWork Location
RemoteHybridImportant To Me
Work-life balanceFlexible work hoursHealthcare benefitsWork from home optionPaid time offPaid sick leave401k matchCareer advancementTimeline
Workflow Coordinator
VSP
12.2021 - Current
Customer Support I
VSP
12.2021 - 03.2022
Small/Large Group Member Processing & Clerical Team Lead
Blue Shield of California
11.2003 - 12.2021
San Joaquin Delta College
Associate of Science from Business
Similar Profiles
ASIMA MUBEENASIMA MUBEEN
System /AWS Cloud Engineer at VSPSystem /AWS Cloud Engineer at VSP
Matthew BowenMatthew Bowen
Optical Technician Level 3 at VSPOptical Technician Level 3 at VSP
Christy EvansChristy Evans
Assistant Provider Specialist at VSPAssistant Provider Specialist at VSP
Teresita ArmasTeresita Armas
Customer Service Representative at Blue Shield of CACustomer Service Representative at Blue Shield of CA
Devin MendozaDevin Mendoza
Network Specialist 1 at Bank of StocktonNetwork Specialist 1 at Bank of Stockton