Beth Clayton
- Role
- Director of Operations at Blue Cross NC
- Location
- Durham, NC, US
- LinkedIn followers
- 500 followers
About Beth Clayton
Experienced Director Of Operations with a demonstrated history of working in the…
Experience
Director of Operations
Dec 2011 — Present
Provide leadership, vision, and direction for the Federal and Medicare divisions. Lead and set goals; Identify, coordinate and implement initiatives/projects and activities that create efficiencies; Optimize systems & processes; Promote quality. Direct multiple business units overseeing areas that include: auditing, operational production oversight, training, policy and procedure development, software administration, software vendor management, production support, operations monitoring & controls, continuous process improvement, system simplification, process re-engineering, program management & oversight, business & data analysis, and project/program delivery. • Oversee Individual and Group Billing for Senior Market • Oversee Complaints to Medicare (CTM) for Senior Market (developed process from cradle to implementation, establishing oversite, governance and procedures and the creation of reporting for tracking, trending and analytics) • Oversee Good Cause Reinstatement for Medicare (developed process from cradle to implementation, establishing oversite, governance and procedures and the creation of reporting for tracking, trending and analytics) • Oversee DOI (Department of Insurance) complaints, throughout operations to ensure escalations are handled and resolved in compliance with Medicare and BCBSNC standards • Manage four cost center budgets
Education
Kennedy-Western University
Bachelor’s Degree, Science in Business Administration
2004 — 2006
Skills
- Data Process
- Business Process Improvement
- Team Building
- Project Management
- Process Improvement
- Leadership
- Claims
- Health Insurance
- Negotiation
- Sales
- Ach
- Program Management
- Microsoft Excel
- Cognos
- Training
- Fulf
- Vendor Management
- Analysis
- Billing
- Analytical Skills
- Customer Satisfaction
- Insurance
- Customer Service
- Change Ag
- Medicare Part a
- Claims
- Management
- Call Centers
- Enroll
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