Experience

Healthcare Management Solutions, LLC

• United States
• Business Consulting and Services
• 1 - 100 Employee

• Compliance Reviewer

  • Mar 2015 - Present

  • Develop action plans to ensure timely completion of audit reviews • Perform research and analysis of data obtained for specific Qualified Health Plan Issuers • Document findings related to Compliance Reviews in a clear, cohesive and precise manner • Use TeamMate audit software extensively for documenting reviews and keeping track of the progress • Prepare final reports and exhibits to summarize findings • Identify findings requiring remediation • Implement correction plans and oversee remediation of the issues through compliance • Create and maintain reports to support contractual and regulatory compliance • Review and update compliance review protocols when new regulations are released to ensure that they reflect the latest information Show less



Managed Care of America

• Claims Supervisor

  • Sep 2014 - Mar 2015

• Auditor

  • May 1991 - Sep 2014



EBC (Managed Care of America)

• Pittsburgh

• Claims Examiner

  • Oct 1989 - May 1991