Joan Weigand-Camardo
Phoenix,AZ
Summary
Experienced with healthcare systems, patient care optimization, and regulatory compliance. Utilizes analytical skills to identify opportunities for improvement and implement effective strategies. Knowledge of healthcare policies and financial management ensures high-quality client service and operational efficiency.
Overview
45
45
years of professional experience
Work History
Healthcare Consultant
Self-employed
09.2018 - Current
- Claims reviews, denials and appeal management
- Community training and outreach for Medicare, third-party and Medicaid recipients
- Patient advocacy
Project Manager
NTT DATA Services
10.2000 - 09.2018
- Successfully led Phoenix, AZ hospital project team for over 10 years, with resolution of Government payer claims, aged from over 60 days to 365+.
- Project team consistently met and/or exceeded monthly resolution and collections targets, with Quality Assurance scores greater than 90% or more.
- Average of 98% account resolution, with improved denial management and claims adjudication, which further reduced Bad Debt write-offs and collections.
- Training and mentoring for client staff and associates, in areas of Compliance, payer updates, Charge Master review and Contracting with commercial payers.
- Preparation of correspondence, accounting and financial documents for analysis in a timely manner for client and company.
- Promoted from Project Manager in 2015.
Healthcare Consultant
Paralign Revenue Management
05.1998 - 10.2000
- Conducted aged claims and contract reviews which yielded support for Corporate grievance against major local health plan that was consistently under-paying or denying facility claims.
- Completed four month Medicare claims review totaling eight million, that resulted in 98% payment rate which reduced aged receivables, corrected credit balances and eliminated bad debt placement.
- Reduced Medicare appeals and Online Claims Editor rejections with consistent daily claims follow-up.
- Claims auditing identified multiple Charge Master errors crucial to compliance standards.
- Assisted in the stream-lining of Health Information Systems record procurement and completion, for discharge coding critical to final billing.
- Successfully reviewed out-patient service billing that needed corrections with bundling/unbundling of charges. This increased compliance and improved facility reimbursement.
Medicare Biller/Consultant
Columbia Health Systems
02.1997 - 05.1998
- Company Overview: Now known as Abrazo
- Successfully trained Medicare Correct Coding Initiatives which reduced compliance flags and billing issues.
- Served as Task Force team leader to assist in the streamline of the admissions and insurance verification processes, which reduced claims rejections, suspensions, and appeals which increased reimbursement.
- Partnered with Business Office leaders to drive enhanced patient registration experience and outcomes, identified areas of opportunity to increase clean claim rates and ensured that payer agreements were in line with performance objectives.
Patient Financial Services Representative III
Genesee Hospital
01.1981 - 11.1996
- Assisted in development, training and implementation of several system conversions.
- Served as Team Leader for State Peer Review (PRO) volunteer task force investigating fraud and abuse in long-term care facilities.
- Functioned as Patient Advocate for state Medicaid applicants denied benefits under long-term care provisions-in twenty cases, all denials were over-turned.
- Successfully executed all insurance verifications and authorizations. Monitored on-going applications for Medicaid, self-pay patients, Medicare patient day usage, Alternate Level of Care patients, processed Medicare cut-offs via Utilization Review, and worked with Social Security Administration as Representative Payee for Long-term care patients.
- Served as Chief Bed Assignment Officer in earlier years. Handled bed placements in this 424-bed metropolitan multi-use facility, at or near 100% occupancy most days.
Education
Healthcare Administration -
Rochester Institute of Technology
Rochester, NY01.1994
Skills
- Results-oriented
- Client-focused
- End-to-End billing processes
- Report generation and analysis
- Time management skills
- Team building and engagement
- Excellent communications
- Healthcare customer service
- Compliance
- Healthcare consulting
- Healthcare advocacy
- Healthcare auditing
Timeline
Healthcare Consultant
Self-employed
09.2018 - Current
Project Manager
NTT DATA Services
10.2000 - 09.2018
Healthcare Consultant
Paralign Revenue Management
05.1998 - 10.2000
Medicare Biller/Consultant
Columbia Health Systems
02.1997 - 05.1998
Patient Financial Services Representative III
Genesee Hospital
01.1981 - 11.1996
Healthcare Administration -
Rochester Institute of Technology
Awards
Unsung Hero, Dell Healthcare Division, 04/2008, Awarded for job excellence and exceeding expectations
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