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Tom Everett, Director of Claims Service Center, ConnectiCare
Biography:
Mr. Thomas Everett is the Director of Claims Service Center at ConnectiCare. Serving in this position for the past five years, his current responsibilities include claims administration for HMO, POS, Individual, PPO, HRA and HSA plans. Other leadership responsibilities include corporate mail and print operations, claims adjudication and payments, code management, medical bill audit, vendor management, liability and recovery, COB & OPL and leading projects. Mr. Everett has held leadership positions in health insurance operations for over 20 years with roles that include account management, call center, business start-ups, system migrations, business systems, analysis and design, imaging applications and document handling. He has served on project teams at the local, state and national levels planning and delivering service to commercial and government customers.

Areas of Expertise:
Claims administration, business systems operations, customer service operations and medical code management. Coordination of Benefits and Other Party Liability, project management, data and performance analysis, business audit and controls, performance management tools and fraud and abuse.

Specific Subjects and Issues for Speaking Appearances & Media Inquiries
Customer service delivery operations and systems that include claims, calls and document management. Policies and practices for benefits management, adjudication logic & systems, reimbursement and billing methodologies. Process improvement innovations to improve customer satisfaction through member and provider centric systems and approached. Audit and control routines and systems to protect financial expenses.

Professional Achievement
Mr. Everett has held leadership positions in health insurance operations for over 20 years with roles that include account management, call center, business start-ups, system migrations, business systems, analysis and design, imaging applications and document handling. He has served on project teams at the local, state and national levels planning and delivering service to commercial and government customers. Has spoken as an expert on business auditing and claims at a number of national conferences such as the World Research Group Health Claims Management Summit. He is a Council Member with the Gerson Lehrman Group.

Educational background
1979, Hudson Valley Community College, Associates of Applied Sciences Degree in Criminal Justice Science
1980, Elmira College, BS in Social Sciences and Technology
Other post graduate course work includes National Other Party Liability & National Health Care Anti-Fraud Associate in 1997.

Background
With over 20 years of experience in leadership positions in health insurance operations, Tom Everett is a leading expert on claims administration and system efficiency and innovations.