Summary
Overview
Work History
Education
Skills
Timeline
Generic
Jenna Alderson

Jenna Alderson

Kansas City,MO

Summary

Skilled Payment Accuracy Specialist with a proven track record at Cotiviti and HMS, specializing in process optimization and quality assurance. Excelled in leadership roles, enhancing operational efficiency and fostering team collaboration. Expert in analytical thinking and quality assessment, significantly improving recovery accuracy. Known for excellent attention to detail and exceptional work ethic. Committed to improving overall business processes.


Overview

10
10
years of professional experience

Work History

Payment Accuracy Specialist 1

Cotiviti
01.2024 - Current
  • Followed all company policies and procedures to deliver quality work.
  • Establish the correct order of liability for HCSC commercial and Medicare members.
  • Participate in on-boarding new hires, offering one-on-one training for Commercial and Medicare review processes.
  • Assist the Research & Development team with testing new recovery tools (Appian) and queries.
  • Ensuring client-facing tasks are completed on time, such as appeals/rebuttals on return files, and Outstanding Case Form requests.
  • Identifies opportunities for improvement for efficiencies within the coordination of benefits research process.
  • Create standard operation procedures for recovering incorrectly paid claims (IPCs).
  • Investigate member files for all Coordination of Benefits concepts to identify recovery opportunities.
  • Assist other Commercial and/or Medicare Specialists by sharing information about successful recovery avenues.
  • Integrate information from various sources to support the accuracy of overpayment recovery.
  • QC PID and Case Form data for quality and accuracy before exporting to Client.
  • QC claims submitted to recovery for accuracy before exporting to Client.

Payment Accuracy Specialist

Cotiviti
11.2016 - 01.2024
  • Create training materials for new hires on the company's procedures and policies.
  • Was the designated Medicare calling representative for my team while meeting and exceeding audit goals
  • Leveraged specialized knowledge to act as subject matter expert within the team
  • Displayed strong telephone etiquette, effectively handling difficult calls.
  • Meet expected levels of quality and quantity for claims written.
  • QC PID and Case Form data for quality and accuracy before exporting to Client.
  • QC claims submitted to recovery for accuracy before exporting to Client.

Insurance Investigative Specialist

West Asset Management (HMS)
02.2015 - 11.2016
  • Analyze imported data for Coordination of Benefits error trends and made corrections for member COB files.
  • Make out-bound phone calls to Commercial insurance providers and/or Medicare to verify eligibility.
  • Support Payment Accuracy Specialists by identifying and inputting the correct Coordination of Benefits order prior to Auditor review.


Education

Associate of Applied Science - Office And Computer Technology

Grayson College
Denison, Texas
05-2019

Skills

  • Quality assurance
  • Experience in leadership
  • Process optimization
  • Coaching and mentoring
  • Operational enhancement
  • Quality assessment
  • Knowledge sharing
  • Team collaboration
  • Analytical thinking

Timeline

Payment Accuracy Specialist 1

Cotiviti
01.2024 - Current

Payment Accuracy Specialist

Cotiviti
11.2016 - 01.2024

Insurance Investigative Specialist

West Asset Management (HMS)
02.2015 - 11.2016

Associate of Applied Science - Office And Computer Technology

Grayson College
Jenna Alderson