Summary
Overview
Work History
Education
Skills
Certification
References
Websites
Professional Development
Timeline
Generic

Debra Hanko

Waunakee

Summary

Healthcare operations, IT, and compliance leader with 15+ years of experience driving claims adjudication, provider enrollment, benefit configuration, and audit functions across Medicaid, Medicare, commercial, and TPA lines of business. Proven expertise in HIPAA, CMS, and state regulatory compliance, revenue cycle management, and EDI transactions (270/271, 276/277, 278, 834, 835, 837, 977/999). Background includes direct experience in IT system support and configuration, partnering with developers, and cross-functional teams to optimize enterprise platforms, and resolving technical issues. Known for analytical thinking, adaptable problem-solving, and a commitment to continuous improvement in payer environments.

Overview

14
14
years of professional experience
1
1
Certification

Work History

Senior Process Improvement Analyst

Premier Inc.
Charlotte
11.2021 - 03.2024
  • Led EDI troubleshooting and system configuration during enterprise claims system rollout, reducing error rates and improving uptime.
  • Implemented No Surprises Act updates by configuring new 835 fields, improving claims accuracy and reducing manual rework by 25%.
  • Ensured HIPAA compliance by analyzing workflows and enhancing data integrity across departments.
  • Streamlined COBRA workflows and developed training modules to support staff accuracy and regulatory transitions.
  • Collaborated across Configuration, Provider, Repricing, and Pharmacy departments to align benefit and provider data.

Operations Quality Monitoring Auditor

Dean Health Plan
Madison
12.2019 - 07.2021
  • Created SOPs and audit tools for provider operations, reducing benefit configuration errors by 30%.
  • Delivered training and coaching that improved audit pass rates by 25%.
  • Documented audit findings that led to corrective actions, reducing compliance issues by 40%.
  • Maintained 100% HIPAA compliance across 50+ audits annually.

Operations Manager – Benefit Administration

Auxiant
Madison
04.2019 - 10.2019
  • Supervised 10+ staff across benefit administration and claims operations, processing 5,000+ claims/month.
  • Oversaw Configuration, Provider, Repricing, and Pharmacy departments, ensuring alignment of benefit and provider data.
  • Enhanced internal repricing tools, reducing manual steps by 40% and increasing stakeholder satisfaction by 25%.
  • Improved processing efficiency by 20% and resolved escalations within 24 hours.

Hosted System Support Analyst

Wisconsin Health Solutions (WPS)
Madison
11.2018 - 04.2019
  • Streamlined nurse assessments by reducing questions from 500 to 75.
  • Led clinical system implementation and optimized software configurations.
  • Partnered with developers to resolve application errors and trained staff on new systems.

Advanced Business Analyst

Dean Health Plan
Madison
12.2009 - 11.2018
  • Redesigned workflows, saving $25K/month by reducing manual tasks.
  • Integrated 278 files into the claims system, improving adjudication accuracy.
  • Resolved COB compliance issues in 835 remittance files, enabling clean imports into Epic.
  • Mentored junior analysts and led cross-functional testing for claims and enrollment changes.

Education

Some College (No Degree) - Liberal Arts Coursework

Madison Area Technical College
Madison, WI

Skills

  • Technical & Regulatory
  • EDI Transactions: 270/271, 276/277, 278, 834, 835, 837, 977/999
  • HIPAA, CMS, and State Compliance
  • System Configuration & Optimization
  • SQL & Excel (Refresher Courses Completed)
  • Microsoft Teams & Office Suite
  • Leadership & Operations
  • Department Oversight: Configuration, Provider, Repricing, Pharmacy
  • Team Supervision & Staff Development
  • Cross-functional Collaboration
  • Training & Performance Coaching
  • Vendor Management
  • Analytical & Process Improvement
  • Claims Adjudication & Enrollment
  • Root Cause Analysis
  • Workflow Redesign
  • Audit Tools & SOP Development
  • Agile / SAFe Methodologies

Certification

  • Certified EDI Professional
  • HIPAA Compliance
  • ITIL Foundations
  • SAFe 4.0 Agile Certification

References

Available upon request.

Professional Development

March 2024 – Present Completed SQL and Excel refresher courses while on planned medical leave. Fully recharged and ready to return to healthcare operations in a leadership capacity.

Timeline

Senior Process Improvement Analyst

Premier Inc.
11.2021 - 03.2024

Operations Quality Monitoring Auditor

Dean Health Plan
12.2019 - 07.2021

Operations Manager – Benefit Administration

Auxiant
04.2019 - 10.2019

Hosted System Support Analyst

Wisconsin Health Solutions (WPS)
11.2018 - 04.2019

Advanced Business Analyst

Dean Health Plan
12.2009 - 11.2018

Some College (No Degree) - Liberal Arts Coursework

Madison Area Technical College

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