Experience

Health Partners Plans

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

• Coordinator

  • Jun 2017 - Present

  Ancillary Medicare Coordinator

• DME Coordinator

  • Nov 2016 - Jun 2017

  Durable Medical Equip



Independence Blue Cross

• United States
• Insurance
• 700 & Above Employee

• Medicare Appeals Team Leader

  • Nov 2014 - Nov 2016

• Medicare Appeals Team Leader

  • Nov 2014 - Nov 2016

  Appeals



Independence Blue Cross

• United States
• Insurance
• 700 & Above Employee

• Medicare Member Appeals Specialist

  • Jun 2007 - 2011

  Investigate, prepare and process Prescription Drug Plan (PDP) Appeals for First Level Committee Review and External Review.Investigate, prepare and process Standard Medical Appeals for First Level Committee Review and External Review.Investigate, prepare and present Medicare beneficiaries Grievance complaints.Prepare policy and procedure for IntegriGuard request to Medicare.Prepare training material and train Specialists on the Grievance and Complaint Tracking Module (CTM) process.Assist the Executive Inquiry Dept. with resolving the member's complaint by deciding how the complaint should be processed. Then investigate, prepare and process the complaint as either a Grievance or an Appeal.Investigate and process CTM complaints.