Chadmer Givens
Gaithersburg,MD
Summary
N/A
Overview
39
39
years of professional experience
Work History
Lead Quality Auditor
CVS HEALTH CORPORATION
03.2022 - 05.2023
- Consistently met or exceeded key performance indicators related to audit completion rates, defect reduction, and process improvements.
- Led cross-functional teams for process improvement initiatives, achieving higher product standards and improved customer satisfaction.
- Managed a team of auditors responsible for conducting on-site inspections at manufacturing facilities, ensuring adherence to established quality protocols.
- Identified areas of improvement through comprehensive audits, resulting in a more robust quality management system.
- Conducted thorough root cause analyses to uncover the sources of recurring issues, effectively reducing defects over time.
- Mentored junior auditors on best practices for conducting thorough inspections and developing clear, concise reports documenting their findings.
Reimbursement Analyst
CVS HEALTH CORPORATION
01.2013 - 03.2022
- Improved reimbursement processes by analyzing and resolving payment discrepancies.
- Participated in cross-functional teams focused on continuous improvement initiatives within the organization''s revenue cycle operations department.
- Boosted financial performance by identifying trends and recommending improvements to reimbursement procedures.
- Conducted audits of patient accounts to identify errors or inconsistencies that could impact timely reimbursements.
- Served as a subject matter expert on specific payers or types of claims, contributing specialized knowledge during internal meetings or presentations aimed at improving overall team effectiveness in handling reimbursement matters.
- Streamlined claims processing for increased efficiency and accuracy in reimbursements.
- Reduced claim denial rates, implementing effective follow-up strategies.
- Maintained a detailed understanding of the organization''s payer mix and reimbursement rates, providing key insights during budget planning or forecasting discussions.
Medicare Appeals and Grievance Specialist
BroadPath Healthcare Solutions
02.2008 - 01.2013
- Providing training and support to new Grievance Specialists, improving team efficiency and skill levels.
- Consistently met performance metrics such as quality scores and case closure rates, demonstrating commitment to excellence in handling customer grievances.
- Maintained detailed records of all grievance cases, ensuring accurate reporting and data analysis opportunities.
- Implemented regular audits of grievance processes, identifying areas for improvement and maintaining compliance with regulations.
Medical Claims Processor
Aetna
03.2000 - 12.2007
- Processed high volumes of medical claims accurately and efficiently under tight deadlines, ensuring prompt payment for services rendered.
- Researched and resolved complex medical claims issues to support timely processing.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Verified patient insurance coverage and benefits for medical claims.
Medicare Claims Processor
Blue Cross Blue Shield of Texas
01.1990 - 02.2000
- Proactively identified potential bottlenecks in the claims process chain, suggesting solutions that led to smoother operations.
- Managed a high volume of daily claims while consistently meeting deadlines and maintaining quality standards.
- Served as a mentor for new hires in the department, sharing best practices for successful Medicare claims processing techniques.
- Maintained up-to-date knowledge on changing Medicare requirements and guidelines, ensuring full compliance at all times.
- Consistently met or exceeded performance metrics within the role by keeping abreast of industry changes and adopting best practices.
- Expedited the resolution of complex cases by conducting comprehensive research and engaging with necessary stakeholders.
Equipment Records and Parts Specialist
United States Army
08.1984 - 01.1987
- Issued parts to technicians to complete customers' repairs.
- Served customers in-store and by telephone to answer questions and place orders.
- Collaborated with service technicians to identify required parts for repairs, minimizing delays and enhancing productivity.
- Provided exceptional customer service by promptly responding to inquiries, resolving issues, and consistently going above and beyond to exceed expectations.
- Maintained a clean and organized work environment, allowing for easy access to frequently used items and efficient completion of tasks.
- Received and restocked product, keeping sales floor shelves full and ready for customers' purchases.
- Provided training to new team members on best practices in parts management, fostering a culture of continuous improvement within the department.
Education
High School Diploma -
Port St. Joe High School
Port Saint Joe, FL06.1984
Skills
N/A
Timeline
Lead Quality Auditor
CVS HEALTH CORPORATION
03.2022 - 05.2023
Reimbursement Analyst
CVS HEALTH CORPORATION
01.2013 - 03.2022
Medicare Appeals and Grievance Specialist
BroadPath Healthcare Solutions
02.2008 - 01.2013
Medical Claims Processor
Aetna
03.2000 - 12.2007
Medicare Claims Processor
Blue Cross Blue Shield of Texas
01.1990 - 02.2000
Equipment Records and Parts Specialist
United States Army
08.1984 - 01.1987
High School Diploma -
Port St. Joe High School
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