Betty White
Turners Station,KY
Summary
Motivated Team Player possessing excellent collaboration and planning abilities. Focused on delivering high-quality products through the use of technology on tight schedules. Maintains, and encourages employees to improve skills and meet demanding targets. History of successfully developing and managing strong teams through training, development of efficiency tools and proactive issue management.
Overview
12
12
years of professional experience
Work History
Team Lead Payment Accuracy
Cotiviti Healthcare
Louisville, KY
05.2021 - Current
- Developed reports from multiple databases by utilizing SQL queries, Excel formulas, graphs, pivot tables and VLookups.
- Performed trend analysis on key performance indicators in order to develop action plans. Results are reported to upper management.
- Identified gaps between current performance levels and desired goals through trend analysis.
- Maintained a database of historical records used for trend analysis purposes.
- Facilitated collaboration and communications between different departments within the organization.
- Responds to inquiries from the client including appeals and guideline changes.
Payment Accuracy Specialist I and II
Cotiviti Healthcare
Louisville, KY
04.2012 - 04.2021
- Developed custom queries using SQL to reduce large volumes of claims into smaller datasets.
- Monitor MLN changes, general CMS website, and Optum Change Reports for potential opportunities for new or enhancing current concepts.
- Utilized PowerPoint, Excel, and SQL tools to develop and implement the Medicaid Line of Business.
- Trained in and performed Quality Reviews for Medicare, Medicaid, and Commercial Facility and Professional claims.
- Researched, developed, and audited multiple concepts for Facility and Professional claims.
Medical Claims Processor
Firstsource Solutions
Louisville, KY
- Analyzed provider contracts to assess reimbursement rates for high-dollar Facility claims.
- Developed process improvements for streamlining contract review workflow processes.
- Developed training program for multiple locations.
- Claims Resolution, adjudication and adjustments for Facility, Professional, Member Submitted and COB claims
Education
Some College (No Degree) - Business Administration
Sullivan University
Louisville, KYSkills
- Performance monitoring
- Regulatory Compliance
- Trend tracking
- Coaching and Mentoring
- Resource Allocation
- Quality Control
Timeline
Team Lead Payment Accuracy
Cotiviti Healthcare
05.2021 - Current
Payment Accuracy Specialist I and II
Cotiviti Healthcare
04.2012 - 04.2021
Medical Claims Processor
Firstsource Solutions
Some College (No Degree) - Business Administration
Sullivan University
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