Summary
Overview
Work History
Education
Skills
Certification
Professional Development & Medical Leave
Timeline
Generic

Debra Hanko

Waunakee,WI

Summary

Healthcare operations 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, healthcare revenue cycle management, and EDI transactions (834/835/837/278). Skilled in process improvement, workflow optimization, and cross-functional collaboration to enhance data quality, operational efficiency, and regulatory adherence. 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.
11.2021 - 03.2024
  • Led EDI troubleshooting, achieving measurable error reduction and improved system uptime.
  • Ensured HIPAA compliance and regulatory adherence by analyzing workflows, enhancing data quality, and reducing audit risks through strengthened data integrity.
  • Implemented No Surprises Act updates by configuring new 835 fields in the system, enhancing claims accuracy and reducing manual rework through effective cross-functional collaboration.
  • Streamlined COBRA workflows, reducing processing time and improving operational efficiency.
  • Developed training modules and documented compliance changes to improve staff accuracy, support smooth transitions, and ensure clear communication.

Operations Quality Monitoring Auditor

Dean Health Plan
12.2019 - 07.2021
  • Created SOPs and audit tools for provider operations, ensuring benefit configurations aligned with employer policies and regulatory requirements across Medicare, Medicaid, ASO, PPO, POS, and EOP lines of business—contributing to a 30% reduction in benefit configuration errors.
  • Delivered training and performance feedback to front-line teams, resulting in a 25% improvement in audit pass rates and increased adherence to provider benefit standards.
  • Documented audit findings that led to corrective actions across multiple departments, reducing compliance issues by 40% and improving turnaround time for resolution by 20%.
  • Handled sensitive provider and member data with discretion, maintaining 100% HIPAA compliance across more than 50 audits annually.

Operations Manager – Benefit Administration

Auxiant
04.2019 - 10.2019
  • Managed benefit plans and claims workflows for over 50 employer groups, ensuring 100% HIPAA compliance and improving processing efficiency by 20%.
  • Supervised a team of 10+ operations staff, maintaining full compliance with company policies and reducing procedural errors by 30%.
  • Enhanced internal repricing tool, reducing manual steps by 40% and increasing internal stakeholder satisfaction scores by 25%.
  • Analyzed claims and enrollment data trends across multiple lines of business, enabling proactive regulatory updates and reducing compliance gaps by 35%.
  • Oversaw daily claims operations for 5,000+ claims/month, resolving escalations within 24 hours and ensuring benefit configurations aligned with provider data across all lines of business.
  • Empowered employees to take ownership of their responsibilities, leading to increased accountability and improved performance outcomes.

Hosted System Support Analyst

Wisconsin Health Solutions (WPS)
11.2018 - 04.2019
  • Streamlined nurse assessments by reducing questions from 500 to 75, significantly improving efficiency.
  • Led clinical system implementation, improving workflows and boosting user satisfaction.
  • Optimized software configurations and updates to enhance system performance.
  • Partnered with developers to resolve application errors by identifying root causes and implementing fixes.
  • Trained staff on new systems, promoting effective technology use and team engagement.

Advanced Business Analyst

Dean Health Plan
12.2009 - 11.2018
  • Redesigned workflows, saving $25K/month by reducing manual tasks and boosting efficiency.
  • Integrated 278 files into the claims system, minimizing errors and accelerating processing by configuring system rules to support accurate adjudication and benefit administration.
  • Resolved COB compliance issues in 835 remittance files, enabling providers to import into Epic without errors and ensuring alignment with industry standards.
  • Analyzed data trends to support decision-making and service delivery; mentored junior analysts to foster collaboration and professional growth.
  • Configured system rules for claims processing and adjudication across all lines of business. Conducted end-to-end testing for claims—including benefit, enrollment, provider, and authorization changes—in collaboration with cross-functional teams.

Education

Liberal Arts Coursework -

Madison Area Technical College
Madison, WI
01.1996

Skills

  • Streamlined provider enrollment and configuration across all lines of business—including TPA, Medicaid, Medicare, and commercial—by partnering with claims, benefits, and IT teams to enhance data accuracy and support compliant claims adjudication
  • EDI Transactions: 270/271, 276/277, 278, 834, 835, 837, 977/999,
  • Strong communicator and collaborator with a track record of building cross-functional relationships and leading high-performing teams
  • Highly organized, adaptable, and self-motivated professional with strong problem-solving, time management, and decision-making skills
  • Experienced in employee training, quality control, and fostering a culture of continuous improvement

Certification

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

Professional Development & Medical Leave

  • March 2024 – Present
  • Completed SQL and Excel refresher courses while on planned medical leave. 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

Liberal Arts Coursework -

Madison Area Technical College