Jacqueline Boldt
Milwaukee,WI
Summary
Adept at enhancing claims management and data analysis processes, I significantly improved efficiency and accuracy at United Health Group. Leveraging expertise in SQL data retrieval and advanced Excel, alongside strong collaboration skills, I led initiatives that streamlined operations and ensured HIPAA compliance, achieving impactful outcomes in claims data analysis and recovery efforts.
Overview
2025
2025
years of professional experience
Work History
Medicare & Medicaid Claims Data Analyst 2
Optum, UnitedHealth Group
11.2021 - 02.2025
- Collaborated with IT team to develop automated tools for more accurate and efficient claims data analysis.
- Enhanced claims processing efficiency by streamlining data analysis procedures and reducing manual tasks.
- Applied specific subject matter knowledge to achieve project objectives and to contribute to impactful outcomes.
- Led and contributed to planning and design of claims-based analytical research and studies.
- Pulled claims data from CMS systems, completed PI redactions and imported data for further analysis.
- Maintained a keen understanding of emerging technologies relevant to the field of data analytics, proposing potential applications to improve current workflows when applicable.
- Developed an extensive knowledge base on industry regulations and guidelines, ensuring that all analyses adhered to compliance requirements.
- Conducted comprehensive root cause analyses following major discrepancies or errors within processed claims data sets.
- Directed claims negotiations within allowable limit of $50k and supported successful litigations for advanced issues.
Medicare & Commercial SR Audit and Recovery
United Healthcare
05.2006 - 11.2021
- Conducted periodic reviews of existing accounts, strategizing new approaches that led to successful account settlements and increased overall recovery rates.
- Assisted in formulating new policies that enhanced account resolution rate through innovation methods.
- Identified opportunities for growth by staying current on market trends and competitor activities within the recovery industry.
- Analyzed account data to identify trends and develop targeted strategies for improvement.
- Managed a high volume of accounts, ensuring timely follow-up and thorough documentation.
- Increased client satisfaction levels by addressing concerns promptly and providing clear explanations regarding their accounts'' status during the recovery phase.
- Administrated organization's database by using database management system to organize and manage data.
- Created computer databases and tested and coordinated changes according to user requirements.
- Trained new team members on company policies, procedures, and best practices in the field of recovery analysis.
- Enhanced recovery rates by implementing efficient strategies and utilizing industry best practices.
- Maintained a thorough understanding of industry regulations, ensuring compliance throughout all aspects of the recovery process.
- Streamlined the recovery process for increased efficiency and improved overall performance.
- Improved communication between departments by developing clear guidelines and establishing regular touchpoints for updates on ongoing cases.
- Participated actively in department meetings sharing valuable insights which led towards better decision making in recovery efforts.
- Maintained confidentiality as per company policy handling sensitive information about clients'' financial situations while working on their cases.
- Developed comprehensive reports to track progress, identify challenges, and provide actionable insights for management review.
- Contributed to team success by sharing knowledge about effective techniques used in resolving difficult cases leading to better results.
- Collaborated with cross-functional teams to optimize recovery efforts and maximize results.
Quality Assurance Analyst Dual Role
Ascension
- Analyzed system requirements to create targeted test cases.
- Monitored software performance post-deployment to identify areas for improvement.
- Conducted root cause analysis for recurring defects to prevent future issues.
- Improved product functionality by analyzing user feedback and implementing necessary changes.
- Mentored and coached team members on QA topics and strategies.
- Participated in regular meetings with cross-functional teams to discuss progress updates, communicate concerns or challenges, and ensure alignment of project goals.
- Streamlined QA processes for increased efficiency and reduced time spent on redundant tasks.
- Maintained comprehensive knowledge of relevant industry regulations and standards, ensuring compliance throughout the QA process.
- Acted as a liaison between the QA team and other departments such as Development, Customer Support, and Product Management, ensuring effective communication throughout all stages of the project lifecycle.
- Supported company in maintaining work environment focused on quality, communication, collaboration, integration, and teamwork.
- Conducted training sessions for junior QA analysts, enhancing their skills and knowledge of industry best practices.
- Ensured customer satisfaction by verifying that products met specifications and functioned as intended before release.
Recovery Specialist
Ascension
- 05.2006
- Supported team members by sharing expertise in reimbursement methodologies and payer contracts analysis.
- Provided exceptional customer service, assisting patients with inquiries related to their insurance coverage and reimbursement status.
- Maintained updated knowledge on insurance policies, coding guidelines, and industry regulations to maximize reimbursement potential.
- Streamlined claims processing for increased efficiency and accuracy in reimbursements.
- Built strong relationships with payer representatives, facilitating efficient communication channels for improved collaboration on claim resolution matters.
- Conducted audits of patient accounts to identify errors or inconsistencies that could impact timely reimbursements.
- Ensured compliance with government regulations through thorough documentation review and adherence to established protocols.
- Maintained a detailed understanding of the organization''s payer mix and reimbursement rates, providing key insights during budget planning or forecasting discussions.
- 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.
- Participated in cross-functional teams focused on continuous improvement initiatives within the organization''s revenue cycle operations department.
- Improved reimbursement processes by analyzing and resolving payment discrepancies.
- Enhanced revenue recovery with diligent monitoring of outstanding payments and submission of appeals.
- Managed high volume caseloads effectively while maintaining strict deadlines for submission of claims or appeals documentation.
Education
High School Diploma -
Cedarburg High School
Cedarburg, WISkills
- HIPAA Regulatory Compliance
- Claims Management
- Personalized Learning Strategies
- Data Quality Assurance
- Data Analysis Proficiency
- Data Report Generation
- Fraud Detection Methods
- Data Analysis Modeling
- SQL Data Retrieval
- Expertise in Advanced Excel
Timeline
Medicare & Medicaid Claims Data Analyst 2
Optum, UnitedHealth Group
11.2021 - 02.2025
Medicare & Commercial SR Audit and Recovery
United Healthcare
05.2006 - 11.2021
Quality Assurance Analyst Dual Role
Ascension
Recovery Specialist
Ascension
- 05.2006
High School Diploma -
Cedarburg High School
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