Experience

Rivet

• United States
• Software Development
• 1 - 100 Employee

• Implementation Manager

  • Feb 2022 - Present

  Work directly with Sales, Account Management and Product Specialists to understand customer requirements and objectives. Collect all the requirements from various departments, stakeholders, and users and coordinate all required effort from various parties. Working with both internal and external teams for successful implementation, act as the direct liaison between Rivet and newly signed customers. Work alongside health systems and clearinghouses to implement all needed aspects. Provide user training and coordinate Go-Live dates.

• Product Specialist

  • Nov 2020 - Feb 2022

  Worked alongside customers in helping them review underpaid lines to verify if they were found correctly. Helping build the payer rules and underpayment functionality to function correctly per healthcare system standard. Used my knowledge in healthcare to do underpayment hours for multiple Rivet customers in helping them find underpaid projects to send to their insurance provider representatives.



Ogden Clinic

• United States
• Hospitals and Health Care
• 300 - 400 Employee

• Contract Specialist

  • Aug 2019 - Sep 2020

  Responsible for investigating and examining denial accounts applying appropriate methods and techniques to resolve issues Monitored claims processed by the insurance carrier to determine if the claim was processed according to the contractual language. Identified training opportunities related to federal guidelines, best practices, and medical record documentation requirements. Conducted research analysis and worked closely with third party payers to answer relevant questions and obtained appropriate information in pursuit of resolving unpaid claims. Collected and analyzed data to formulate recommendations and solutions based on audit trends and results. Review Medical Policies and reimbursement guidelines, while working closely with all insurance provider representatives. Also responsible for reviewing and verify current contracts.



R1 RCM

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Contract Monitoring

  • Jan 2018 - Mar 2019

  Monitored claims processed by the insurance carrier to determine if the claim was processed according to the contractual language. Identified training opportunities related to federal guidelines, best practices, and medical record documentation requirements. Conducted research analysis and worked closely with third party payers to answer relevant questions and obtained appropriate information in pursuit of resolving unpaid claims. Collected and analyzed data to formulate recommendations and solutions based on audit trends and results.



Intermountain Health

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Appeals Specialist

  • Sep 2014 - Jan 2018

  Responsible for investigating and examining denial accounts applying appropriate methods and techniques to resolve issues. Followed through with unresolved accounts, provided feedback to the appropriate staff on where the process went wrong. Kept staff educated on all current trends in the appeals arena. Utilized computer systems/programs, processes, policies and procedures. Would trouble-shoot issues as they arose.

• Enhanced Registrar

  • Aug 2010 - Sep 2014

  Preformed registration and basic insurance verification information. Translated physician orders for appropriate testing and or admission criteria. Identified non-participating insurances or out of network plans and took necessary steps to inform the patient regarding options. Provided courteous and accurate patient and hospital information.