Implementation Analyst- Enrollment and Member Management

• Apr 2022 - Present

•Categorize and translate carrier partner error messages into actionable feedback for our tech platform partners and insurance carriers. •Review and analyze EDI 834 and API transmissions to facilitate data transfer to our carrier partners. •Work closely with external partners to resolve member enrollment issues and escalations. Identify process improvements and modifications to Vericred's in-house back-office software. •Ensure daily work and follow ups are… Show more •Categorize and translate carrier partner error messages into actionable feedback for our tech platform partners and insurance carriers. •Review and analyze EDI 834 and API transmissions to facilitate data transfer to our carrier partners. •Work closely with external partners to resolve member enrollment issues and escalations. Identify process improvements and modifications to Vericred's in-house back-office software. •Ensure daily work and follow ups are completed timely and accurately. Show less •Categorize and translate carrier partner error messages into actionable feedback for our tech platform partners and insurance carriers. •Review and analyze EDI 834 and API transmissions to facilitate data transfer to our carrier partners. •Work closely with external partners to resolve member enrollment issues and escalations. Identify process improvements and modifications to Vericred's in-house back-office software. •Ensure daily work and follow ups are… Show more •Categorize and translate carrier partner error messages into actionable feedback for our tech platform partners and insurance carriers. •Review and analyze EDI 834 and API transmissions to facilitate data transfer to our carrier partners. •Work closely with external partners to resolve member enrollment issues and escalations. Identify process improvements and modifications to Vericred's in-house back-office software. •Ensure daily work and follow ups are completed timely and accurately. Show less

Data Operator III

• Dec 2021 - Apr 2022

•Operatekeyboard-controlled data entry to transcribe data into a format suitable for computer processing. •Operate an alphanumeric keyboard, and an understanding of data processing procedures and project computer systems and software. •Operatekeyboard-controlled data entry to transcribe data into a format suitable for computer processing. •Operate an alphanumeric keyboard, and an understanding of data processing procedures and project computer systems and software.

Customer Service Representative

• Sep 2020 - Dec 2021

•Manage direct service to the public as the first point of contact. •Assist beneficiaries or inquirers in person, by telephone or in writing to provide information on SSA laws, rules and regulations and Medicare Insurance Programs. •Obtain information in order to determine eligibility and entitlement for programs administered by SSA, and using automation tools to access and update information about claims or potential eligibility. •Provide assistance to beneficiaries and the general… Show more •Manage direct service to the public as the first point of contact. •Assist beneficiaries or inquirers in person, by telephone or in writing to provide information on SSA laws, rules and regulations and Medicare Insurance Programs. •Obtain information in order to determine eligibility and entitlement for programs administered by SSA, and using automation tools to access and update information about claims or potential eligibility. •Provide assistance to beneficiaries and the general public in person, by telephone, or in writing. •Conduct interviews to determine the nature of the caller's question or issue; explain technical information, gather facts, evaluate evidence, and take action to resolve problems relating to all Social Security programs. Show less •Manage direct service to the public as the first point of contact. •Assist beneficiaries or inquirers in person, by telephone or in writing to provide information on SSA laws, rules and regulations and Medicare Insurance Programs. •Obtain information in order to determine eligibility and entitlement for programs administered by SSA, and using automation tools to access and update information about claims or potential eligibility. •Provide assistance to beneficiaries and the general… Show more •Manage direct service to the public as the first point of contact. •Assist beneficiaries or inquirers in person, by telephone or in writing to provide information on SSA laws, rules and regulations and Medicare Insurance Programs. •Obtain information in order to determine eligibility and entitlement for programs administered by SSA, and using automation tools to access and update information about claims or potential eligibility. •Provide assistance to beneficiaries and the general public in person, by telephone, or in writing. •Conduct interviews to determine the nature of the caller's question or issue; explain technical information, gather facts, evaluate evidence, and take action to resolve problems relating to all Social Security programs. Show less

Applications Credentialed Trainer

• Aug 2020 - Sep 2021

•Facilitate end-user training for applications across the Nebraska Medicine enterprise and community connect partners. This includes end-user classroom training using curriculum developed by the Applications Trainer, management/coordination of attendees in the Learning Management System, assigning/updating system access requests, classroom set up and coordination, preparation of classroom materials, and appropriate follow up on tasks/items post training completion. •Assist with additional… Show more •Facilitate end-user training for applications across the Nebraska Medicine enterprise and community connect partners. This includes end-user classroom training using curriculum developed by the Applications Trainer, management/coordination of attendees in the Learning Management System, assigning/updating system access requests, classroom set up and coordination, preparation of classroom materials, and appropriate follow up on tasks/items post training completion. •Assist with additional job functions such as updating training materials, testing lesson plans, providing at the elbow support to end users, administering test outs and assessments, or other training related tasks. •Review and communicate changes and/or updates needed to curriculum to the Applications Trainer in a timely manner

Patient Financial Counselor

• Dec 2019 - Aug 2020

•Provide customer service by screening accounts and taking referrals, identifying patient financial needs, assessing needs through patient interview, formulation of a strategy, and assisting the patient as needed to complete all necessary requirements to enable the patient to meet their financial obligation to the organization. •Verify insurance eligibility and benefit information, collect co-payments, obtain prior authorizations and facilitate identification of available coverage and/or… Show more •Provide customer service by screening accounts and taking referrals, identifying patient financial needs, assessing needs through patient interview, formulation of a strategy, and assisting the patient as needed to complete all necessary requirements to enable the patient to meet their financial obligation to the organization. •Verify insurance eligibility and benefit information, collect co-payments, obtain prior authorizations and facilitate identification of available coverage and/or financial application process. •Provide support for organizational research through completion of proactive payer medical review determination. •Complete applications for coverage through Medicaid, Marketplace and/or disability, monitor status, and assist patients with scheduling of hearings or other items as required. •Complete cost estimates and follow guidelines associated with pre-payment process. Face to face and bedside patient contact required.

Implementation Project Manager

• Jan 2019 - Dec 2019

•Develop working knowledge of project development process, working with internal managers and supervisors, communicating frequently and escalating issues as necessary. •Utilize big picture analysis to identify efficiencies, opportunities, and strategies to increase departmental scope, customer base and/or expansion of product set. •Assist management staff to organize tasks, time, resources, and people to create a project where all elements come together to repeatedly produce an end… Show more •Develop working knowledge of project development process, working with internal managers and supervisors, communicating frequently and escalating issues as necessary. •Utilize big picture analysis to identify efficiencies, opportunities, and strategies to increase departmental scope, customer base and/or expansion of product set. •Assist management staff to organize tasks, time, resources, and people to create a project where all elements come together to repeatedly produce an end result. •Plan and organize work by setting, prioritizing, and adjusting schedules to accommodate sudden changes or unexpected assignments. •Document all communications, actions plans, processes, issues and problems thoroughly and professionally. •Assist in coordinating, leading, and attending project meetings and other meetings as requested. •Conduct requirements review and configure system setup as needed. •Conduct online training with institutions, instructing them on all aspects of the products they are implementing. •Assist in creating and implementing efficiencies in processes as identified during projects or process reviews •Assist in developing workflow, processes and procedures for new products or services. •Assist in preparing internal and customer facing documentation such as user guides, training manuals and communication templates. •Understand customer implementation business needs, advocate for customer priorities and build relationships with customers. Show less •Develop working knowledge of project development process, working with internal managers and supervisors, communicating frequently and escalating issues as necessary. •Utilize big picture analysis to identify efficiencies, opportunities, and strategies to increase departmental scope, customer base and/or expansion of product set. •Assist management staff to organize tasks, time, resources, and people to create a project where all elements come together to repeatedly produce an end… Show more •Develop working knowledge of project development process, working with internal managers and supervisors, communicating frequently and escalating issues as necessary. •Utilize big picture analysis to identify efficiencies, opportunities, and strategies to increase departmental scope, customer base and/or expansion of product set. •Assist management staff to organize tasks, time, resources, and people to create a project where all elements come together to repeatedly produce an end result. •Plan and organize work by setting, prioritizing, and adjusting schedules to accommodate sudden changes or unexpected assignments. •Document all communications, actions plans, processes, issues and problems thoroughly and professionally. •Assist in coordinating, leading, and attending project meetings and other meetings as requested. •Conduct requirements review and configure system setup as needed. •Conduct online training with institutions, instructing them on all aspects of the products they are implementing. •Assist in creating and implementing efficiencies in processes as identified during projects or process reviews •Assist in developing workflow, processes and procedures for new products or services. •Assist in preparing internal and customer facing documentation such as user guides, training manuals and communication templates. •Understand customer implementation business needs, advocate for customer priorities and build relationships with customers. Show less

Senior Provider Relations Operations Advocate

• Jan 2018 - Sep 2018

•Assist in end-to-end provider claims and help enhance call quality Coach, provide feedback and guide others • Assist in efforts to enhance ease of use of physician portal and future services enhancements. • Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice MANAGERS. • Help implement training and development of external providers through education programs. • Identify gaps in network… Show more •Assist in end-to-end provider claims and help enhance call quality Coach, provide feedback and guide others • Assist in efforts to enhance ease of use of physician portal and future services enhancements. • Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice MANAGERS. • Help implement training and development of external providers through education programs. • Identify gaps in network composition and services to assist network contracting and development teams. Show less •Assist in end-to-end provider claims and help enhance call quality Coach, provide feedback and guide others • Assist in efforts to enhance ease of use of physician portal and future services enhancements. • Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice MANAGERS. • Help implement training and development of external providers through education programs. • Identify gaps in network… Show more •Assist in end-to-end provider claims and help enhance call quality Coach, provide feedback and guide others • Assist in efforts to enhance ease of use of physician portal and future services enhancements. • Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice MANAGERS. • Help implement training and development of external providers through education programs. • Identify gaps in network composition and services to assist network contracting and development teams. Show less

Revenue Cycle Manager

• Jan 2016 - Dec 2017

•Review forms and reports and confer with management and users about format, distribution, and purpose, and to identify problems and improvements. • Document findings of study and prepare recommendations for implementation of new systems, procedures, or organizational changes. • Design, evaluate, recommend, and approve changes of forms and reports. • Manage, analyze and trend data for 40 analyst. • Recommend and implement solutions to improve first pass denial rates and reduce age… Show more •Review forms and reports and confer with management and users about format, distribution, and purpose, and to identify problems and improvements. • Document findings of study and prepare recommendations for implementation of new systems, procedures, or organizational changes. • Design, evaluate, recommend, and approve changes of forms and reports. • Manage, analyze and trend data for 40 analyst. • Recommend and implement solutions to improve first pass denial rates and reduce age of overall AR • Review and validate reimbursement request • Create workflows and standard operating procedures • Ensure all items are completed within the set turnaround time within quality expectations.

Allscripts Trainer

• Nov 2015 - Dec 2017

Sr Accounts Receivable Associate

• Sep 2015 - Dec 2017

The Senior AR Associate serves as a Subject Matter Expert (SME) for AR Follow-up within client-focused revenue cycle operations and assists coworkers and the Service Manager with questions and escalations as well as communicating issues, trends, concerns and suggestions to leadership.

Medical Billing

• Jun 2014 - Sep 2015

Patient Access Specialist

• Apr 2010 - Jun 2014

• Review records for completeness, accuracy, and compliance with regulations. • Retrieve patient medical records for physicians, technicians, or other medical personnel. • Enter data, such as demographic characteristics, history and extent of disease, diagnostic procedures, or treatment into computer. • Process patient admission or discharge documents. • Post medical insurance billings. • Develop in-service educational materials. • Collect co-pay at time of service • Review records for completeness, accuracy, and compliance with regulations. • Retrieve patient medical records for physicians, technicians, or other medical personnel. • Enter data, such as demographic characteristics, history and extent of disease, diagnostic procedures, or treatment into computer. • Process patient admission or discharge documents. • Post medical insurance billings. • Develop in-service educational materials. • Collect co-pay at time of service