Gregory Ward

About Gregory Ward

As Operations Specialist I am responsible for the resolution of inquiries and/or activities which may include claims, plan policies, products, rates, membership, enrollment, underwriting, direct sales and/or program engagement. The Operations Specialist may also provide cross-functional support for operational functions, which may include one-on-one training, auditing, fulfillment, and/or root cause analysis.

Experience

1. Compliance Associate

   Blue Cross NC

   Aug 2024 — Present · Durham, NC

   Identify and document escalated, recurring or complex system and process problems. Interface with project teams to resolve these complex issues.• Serve as a subject matter expert for employees’ inquiries around work process, procedures, products, policies, etc.• Develop and maintain assigned reports (i.e. team level, inventory) on a daily, or as required basis.• Identify problems, gaps or inconsistencies in workflows, and/or processes; recommend updates, alternatives and/or solutions.• Act as a point of contact for internal and/or external audits and projects as necessary; assist in planning, scoping, testing, training and implementation.• Place outbound calls to various providers, customers or other outside contacts.• Monitor and evaluate operational processes and interactions for quality assurance purposes as requested.• Handle special projects as necessary; create and report on project data analysis.• Customer Service and Sales (in addition to above):• Act as the first level of escalation for more complex customer, provider, and/or group sales problems and/or complaints. • Identify quality trends related to inquiries received from internal/external customers and recommend updates to internal quality gaps. Work to reduce or eliminate the error.• Provide cross functional support between customer service and sales professionals and membership, underwriting and claims departments.• Provide coaching to Customer Service and Sales Professionals by assisting them with customer calls and inquiry research.• May work with case managers and be assigned advanced one-on-one personalized care for members.• Claims (in addition to above):• Process a variety of customer transactions that may include suspended claims, inquiries, adjustments, and/or correspondence.

Education

• North Carolina Central University

  BA

  1983 — 1987

• Pfeiffer University

  MHA

  2003 — 2005

Skills

• Quality Control
• Time Management
• Healthcare
• Microsoft Word
• Customer Service Training
• Customer Service
• Management
• Insurance
• Troubleshooting
• Marketing
• Accounts Receivable
• Training
• Fundraising
• Data Entry
• File Management
• Software Documentation
• Organizational Development
• Powerpoint
• Microsoft Excel
• Performance Management
• Policy
• Leadership