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I am a Healthcare Consultant Professional with over 10 years of combined experience in Managed Care Insurance, Medical Claims, Patient Registration and Provider Relations. In college, my area of study was in Health Science and Liberal Arts.
While working at United Healthcare in Provider Network Management, I noticed many medical providers and their staff struggled with managing claims issues, patient insurance, and health plan contracts. This was the start of my...
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My qualifications include:
-Recipient of the Top Quality Assurance award in patient registration data entry and insurance accuracy at a large hospital.
-Recovered $4+ million in claim payments (otherwise lost revenue) for a large hospital.
-Negotiated and contracted 200+ healthcare providers with a major health insurance company in the US.
-Managed 25 + markets of in-network healthcare providers addressing fee schedule changes, demographic changes, product education, claims issues and contract management.
-Led a special project team in recovering $5+ million in claim overpayments at a major health insurance company in the US.
-I co-developed a new streamlined internal audit and training program at a major health insurance company for our physician contract loading team. The result measured a 20% increase in employee production, 43% increase in quality standards and a 41% increase in provider network satisfaction within 2 years.
How My Services Can Improve Your Business:
A). Is your staff having a hard time managing your patient appointments?
-I will call, email or text reminders to patients of their upcoming appointments and schedule new appointments.
-Make sure appointments do not overlap by managing your appointment calendar.
-Handle missed or no show appointments by following up with patients.
B). Need help with verifying the patient’s insurance PRIOR to appointments?
-I will call to verify insurance at least 1 week prior (or more) to appointment time...
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Sr. Provider Data Analyst
2007 - 2014
Network Management and Business Operations: Claims, Data Entry, Contracting, Project Management, Auditing.