Experience

Molina Healthcare of Wisconsin, Inc.
• United States
• Medical Practices
• 1 - 100 Employee
• Director-Provider Network Administration

  • Feb 2023 - Present


Dean Health Plan, Inc.

• United States
• Insurance
• 300 - 400 Employee

• Director of Provider Network Administration

  • Jun 2019 - Feb 2023

• Manager Provider Network Services

  • Nov 2016 - Jun 2019

• EDI Team Lead

  • May 2015 - Nov 2016


HIPAA-COW (HIPAA Collaborative of WI)
• EDI Co-Chair

  • Feb 2015 - Jan 2017


Safe Bridge Solutions

• Australia
• Retail Health and Personal Care Products
• 1 - 100 Employee

• Consultant

  • Jan 2013 - May 2015

  Business Analyst for the ICD-10 Remediation Project • Lead team of analysts and all analysis efforts for the ICD-10 project for 100+ interfaces, applications, and business processes to adhere to client’s SDLC standards and HHS Federal Mandate as enforced by CMS • Conduct requirement documentation reviews and approvals to ensure quality standards for textual and visual analysis elements such as functional requirements, validation requirements, context diagrams and swim lanes • Perform analysis and impact assessments for all claims related components such as claim adjudication system, compliance edits, and vendor managed solutions • Raise opportunities to better leverage HIPAA 5010 standards such as bringing in data elements to better define subrogation prospects and improve completeness of reporting • Develop and maintain effective relationships with business stakeholders through requirement walkthroughs, industry claims experience, and project expertise • Facilitated conceptual analysis with various business areas to define project scope and estimated effort per value stream and defined business unit Show less


WI BADD
• Speaker Committee Chairperson

  • Dec 2012 - May 2013


Hewlett Packard

• United States
• Information Technology & Services
• 300 - 400 Employee

• Business Analyst Lead

  • Apr 2012 - Dec 2012

  •Responsible for all system changes and maintenance for the web interface to Wisconsin Medicaid for providers, trading partners, and MCOs•Subject matter expert on the ForwardHealth Portal for cross-functional projects and resource estimates•Project manager and lead analyst for projects under 500 hours responsible for requirements gathering, definition and analysis, project planning, and work coordination with developers and testing staff•Develop close working relationships with the clients through frequent communication of project plans, status reports, implementation plans and issue resolution•Prepare test plans, test cases, and managed system defects to account standards•Train internal and external staff on the systems change management process Show less

• Business Analyst

  • Jul 2010 - Apr 2012

  •Performed analysis, testing, and implementation of HIPAA 5010 standards for the 837 Institutional transaction on behalf of Wisconsin Medicaid•Wrote 837 Institutional, Professional, and Dental Companion Guides for claims submissions•User Acceptance Testing Mentor for HIPAA 5010 standards on behalf of the State of Wisconsin•Analyzing system requirement for the federally required ICD-10 project for policy and system impacts•Awarded the HP E-award in 2011 for outstanding leadership and performance•Additional experience in Wisconsin Medicaid claims pricing Show less

• Promotions Chairperson

  • Jan 2012 - May 2012


Professional Women's Association of Budapest

• Marketing Chairwoman & Secretary

  • Aug 2009 - May 2010

  • Nominated and elected by association members to lead marketing efforts of the organization • Main responsibilities: development of event invitations and press releases • Cultivated relationships between the organization and media outlets which directly increased attendance • Increased year-on-year attendance at events by 60% • Redesigned organization’s events format to increase value proposition of corporate and individual members • Project Manager, responsible for development and distribution of organizations marketing materials • Key recruiter for new membership generation Show less



MS City Treuhand

• Marketing Coordinator

  • Jun 2009 - May 2010

  • Designed and wrote all copy for the company website • Led marketing campaign to increase English speaking client base • Developed the business English language of colleagues • Attended European conferences on business development and corporate policies • Designed and wrote all copy for the company website • Led marketing campaign to increase English speaking client base • Developed the business English language of colleagues • Attended European conferences on business development and corporate policies



American Family Insurance

• United States
• Insurance Agencies and Brokerages

• Intern

  • May 2005 - Aug 2008

  •Developed Excel spreadsheets that are now used company-wide. Designed to track all outside representatives’ claims over time and comparative functions to keep consistency between representatives’ workloads. •Led and trained employees on claims dispatching procedures and strategies. Held influential position in redesigning territories for claims representatives by giving data on claims volume by area and average workloads. •Handled the opening, closing, customer service, payments, and representative tracking for 9,834 catastrophe auto claims for the 2006 hail storm throughout the South Central Wisconsin area. (The next largest catastrophe even in Wisconsin in 2006 totaled 1,316 auto claims.) Show less



Sigma Benefits

• United States
• Insurance

• Marketing Intern

  • Sep 2007 - Dec 2007

  •Head of the image and logo redesign project. Used an evaluation of company goals and target markets to transform logo and image into a recognizable brand with clear and concise business goals to attract a key target market. •Created information system database in Access to easily enter and analyze customer data. •Led training on the information system including developing an instruction manual for proper use and maintenance. •Recognized for outstanding customer service. Generated the most prospective customer leads through cold calls and lead generation. Provided continuous customer service through status calls and handling customer concerns. Show less