Abbigale Akstulewicz
Shawano,WI
Summary
Workers Compensation Ancillary Benefits professional with extensive experience in complex discharge planning, as well as service fulfillment for home care and therapy services on a national scale. Skilled in conducting metric reviews and data extrapolation as it pertains to efficient operations. Collaborative and committed to staying updated on best practices to achieve favorable outcomes for Carriers.
Overview
7
7
years of professional experience
Work History
Supervisor Claims Specialist, Workers Compensation
CorLife Dba NuMotion
De Pere, WI
04.2022 - Current
- Develop and execute strategic plans to help achieve departmental and company goals.
- Independently interview, hire, onboard and train new team members.
- Oversee operations and compliance activities of the assigned team.
- Despond to all internal and external customers and inquiries in a timely and professional manner.
- Provide on-going coaching and mentoring to at risk employees.
- Track all company performance metrics, report as needed and extrapolate data to identify patterns.
- Establish solutions for cycling concerns and handle communication and deployment of changes to the internal team.
- Manage at risk vendor, carrier and customer relationships efficiently.
Lead Claims Specialist
CorLife Dba NuMotion
De Pere, WI
05.2021 - 04.2022
- Assist with mentoring and training of team members as needed.
- Assist with departmental/company projects and initiatives.
- Anticipate and track operational and tactical risks and provide strategic solutions.
- Assists with recruiting and performance management.
- Maintains communication with staff and management o ensure an efficient operation flow.
- Reviews all new claims and establishes a plan of action to achieve favorable claim resolution.
- Reviews claims status, action plans and reserves consideration of client cost.
- Searches for new Home Care agencies, ATPs, DME companies, vendors, etc.
- Manages billing, quoting and negotiating rates with adjusters and vendors.
Claims Specialist
CorLife Dba NuMotion
De Pere, WI
12.2019 - 05.2021
- Review all new claims and establish a plan of action to achieve favorable claim resolution.
- Review claim status, action plans and reserve consideration of client cost.
- Advocate, consult and provide coverage and advise to clients as apporpriate.
- Search for new Home Care agencies, ATPs, DME companies, vendors, etc.
- Manage billing, quoting and negotiation rates with adjusters and vendors.
PCW
Community Alternatives
Shawano, WI
09.2015 - 12.2019
- Monitored and maintained cleanliness, sanitation, and organization of assigned station and service areas.
- Assisted patients with self-administered medications.
- Recognized and reported abnormalities or changes in patients' health status to case manager.
- Monitored and assisted residents through individual service plans.
- Provided safe mobility support to help patients move around personal and public spaces.
- Cleaned house, ran errands, managed laundry, and completed weekly grocery shopping.
- Helped clients maintain optimal health by overseeing medication administration and doctor's appointments.
- Documented vitals, behaviors, and medications in client medical records.
- Determined specific needs and provided most appropriate level of services for patient well-being.
Education
Associate of Applied Science - Nursing
09.2019
Skills
- Claims Adjustments
- Compensation Administration
- Analyzing Claims
- Workers Compensation
- Healthcare Terminology
- Policy and Procedure Management
- Proactive Communication
- Patient Intakes
- HIPAA Guidelines
- Quarterly Reviews
- Employee Timesheet Processing
- Diagnostic Codes
Accomplishments
- Upcoming panelist at the 2023 IRSG Conference, speaking on The Catastrophic Case Management and Home Health in a "Post" COVID-19 World with other experts in the field.
Timeline
Supervisor Claims Specialist, Workers Compensation - CorLife Dba NuMotion
04.2022 - Current
Lead Claims Specialist - CorLife Dba NuMotion
05.2021 - 04.2022
Claims Specialist - CorLife Dba NuMotion
12.2019 - 05.2021
PCW - Community Alternatives
09.2015 - 12.2019
Rasmussen College - Associate of Applied Science, Nursing