Summary
Overview
Work History
Education
Skills
Certification
References
Timeline
Generic

Breck Obermeyer

Yakima

Summary

Proven leader in Medicare compliance and relationship management, I excelled at Health Alliance Medical Plans, saving the company millions through meticulous investigations and strategic defense tactics. Skilled in policy development and effective communication, I significantly enhanced compliance processes and fostered strong community ties, driving substantial growth and reducing CMS debt.

Overview

15
15
years of professional experience
1
1
Certification

Work History

MEDICARE COMPLIANCE ANALYST

HEALTH ALLIANCE MEDICAL PLANS
12.2022 - Current
  • I was responsible for researching, interpreting, and communicating statutory, regulatory, and CMS requirements related to the Medicare line of business
  • I provided clear responses to compliance inquiries and ensured alignment with all regulations
  • Additionally, I contributed to the development of member-required materials, reviewed and approved marketing materials, and managed the submission of these materials into HPMS
  • I also created and maintained policy and procedure documents and developed walkthrough help guides, which helped streamline internal processes and enhanced team understanding of complex compliance requirements
  • My primary focus was on Medicare Secondary Payer cases, where I managed the investigation, response, and recoupment of funds from CRC/CMS
  • Through diligent analysis and strategic defense tactics, my predecessor and I successfully saved $9.65 million of the $10.2 million billed to the company by Medicare, significantly reducing financial exposure to the organization
  • Managed the distribution of CMS Memo publications related to various lines of business through OMT, ensuring they were appropriately assigned to the relevant departments
  • Conducted audits to verify compliance with memo guidelines, tracked responses for adherence, and proactively followed up on overdue tasks to ensure timely completion
  • Conducted thorough research on inquiries directed to the Compliance office, interpreting Medicare laws, regulations, and CMS guidelines to provide accurate and timely responses
  • Led efforts to significantly reduce Medicare Secondary Payer cases and associated debt, focusing on resolving and closing outstanding cases while fostering a strong working relationship with our CRC representative
  • In 2024, I independently managed over 200 new cases and successfully closed more than 50 legacy cases, resulting in a substantial reduction in our CMS balance and the recoupment of significant funds for the organization

COMMUNITY, BROKER AND PROVIDER LIAISON

HEALTH ALLIANCE MEDICAL PLANS- HEALTH ALLIANCE NORTHWEST
08.2015 - 12.2022
  • Establishes and maintains relationships within the community, brokers and providers
  • Develop new sales
  • Promotes products in compliance with Centers for Medicare & Medicaid Services marketing guidelines
  • Work with agencies and community contacts focused on serving the community and Medicare beneficiaries within designated service areas
  • Serves as liaison between the Health Plan and community leaders or organizations serving the community
  • Develops, plans, organizes and/or conducts orientation, training, and education meetings/programs
  • Provides assistance, clarification, and resolutions to problems/concerns for various types of providers, including billing, reimbursement, referrals, authorizations, etc
  • Works with key providers and/or risk partners in maintaining an adequate provider network by identifying provider network gaps in assigned territories
  • Evaluates and recommends sponsorship opportunities and represents in person at community events, presentations, expos and health fairs
  • Participates in identification of promotional materials and specialty items for distribution
  • Coordinates, hosts and/or speaks at community events
  • Meets with Medicare beneficiaries to educate on Medicare and programs available to them
  • In compliance with both the Division of Insurance and Centers for Medicare & Medicaid Services sales and marketing regulations, markets products in designated sales territory working to meet or exceed annual sales goal
  • Pursues leads generated by internal marketing efforts and seeks out new prospects through networking
  • Screens prospects for plan eligibility and ensures application requirements are fulfilled
  • Performs administrative tasks such as maintaining records and preparing reports on monthly activity
  • Serves as primary interface for brokers and broker staff providing education on features, advantages and limitations of products, eligibility and Health Alliance policies and procedures in order to promote sales
  • Recommends and initiates new broker contracts or contract terminations
  • Performs Compliance monitoring and oversight to ensure contracted brokers and broker staff are adhering to marketing regulations established by the Centers for Medicare & Medicaid

OWNER

AKURI CREATIVE
01.2010 - 01.2017
  • Created and produced custom designs for various clients
  • Maintained customer relationships
  • Maintained financials

COMMUNITY RELATIONS DIRECTOR

FIELDSTONE MEMORY CARE
06.2014 - 09.2014
  • Increased sales production from two sales a month to an average of one sale a week
  • Created marketing materials, updated materials and created online social media presence

ADMISSIONS AND MARKETING DIRECTOR

GOOD SAMARITAN HEALTH CARE CENTER
08.2013 - 06.2014
  • Improved relationships with top referral sources; discharge planners, surgeons/doctors and decision-making family member(s)
  • Increased marketing data by 90% by creating initial admission marketing surveys and discharge satisfaction surveys
  • Reduced unnecessary marketing costs by consistently monitoring what advertising avenues our target markets are focused on

Education

Bachelor of Arts - Public Relations

Central Washington University
Ellensburg, WA
06-2010

Associate of Applied Science - Graphic Science

Yakima Valley Community College
Yakima, WA
06-2003

Certificate of Technical Studies - Graphic Design

Perry Technical Institute
Yakima, WA
06-2003

Skills

  • Data analysis
  • Research skills
  • Relationship management
  • Problem solving
  • Project management
  • Effective communication
  • Attention to detail
  • Compliance monitoring
  • Investigations expertise
  • Goal setting
  • Policy development
  • Policy writing

Certification

  • State of Washington Office of the Insurance Commissioner
    Insurance Producer License – Disability
    08/2015- Current

References

References available upon request.

Timeline

MEDICARE COMPLIANCE ANALYST

HEALTH ALLIANCE MEDICAL PLANS
12.2022 - Current

COMMUNITY, BROKER AND PROVIDER LIAISON

HEALTH ALLIANCE MEDICAL PLANS- HEALTH ALLIANCE NORTHWEST
08.2015 - 12.2022

COMMUNITY RELATIONS DIRECTOR

FIELDSTONE MEMORY CARE
06.2014 - 09.2014

ADMISSIONS AND MARKETING DIRECTOR

GOOD SAMARITAN HEALTH CARE CENTER
08.2013 - 06.2014

OWNER

AKURI CREATIVE
01.2010 - 01.2017

Bachelor of Arts - Public Relations

Central Washington University

Associate of Applied Science - Graphic Science

Yakima Valley Community College

Certificate of Technical Studies - Graphic Design

Perry Technical Institute

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Breck Obermeyer