Summary
Overview
Work History
Education
Skills
Work Availability
Timeline
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Julianne Luong-Willingham

MSP Medicare Recovery QA Specialist

Summary

A friendly customer service professional, skilled with over 19 years of experience in problem-solving and responsiveness to the needs of the client, coworkers, and management. Poised, resourceful, and adaptable to any office environment. Adept at the organizational ability to handle multiple priorities, work independently, collaborate, and meet deadlines. Proficient in detail and organizational skills, with a sharp awareness of omission/inaccuracies and prompt to take action. Self-motivated and quick learner, eager to assume increasing levels of responsibility. Organized and dependable candidate successful at managing multiple priorities with a positive attitude and open communication. Willingness to take on added responsibilities to meet team goals. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management, and problem- solving skills. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.

Overview

17
17
years of professional experience
4
4
years of post-secondary education

Work History

MSP Medicare Recovery QA Specialist II

Chickasaw Nation Industries, Inc
Oklahoma City, OK
04.2007 - Current
  • Claims management experience & quality assurance-Identifying incorrect Medicare primary paymentsand initiating recovery cases under established processes and federal compliance laws over 16 years ;
  • Maintains knowledge of Workers Comp, Liability, & No-Fault insurance law to determineappropriate level of risk management, Medicare reimbursement under federal compliancestatute 42 U.S.C
  • 1395y(b)(2)(A); recover over $10 million in 2022
  • Communicates with attorneys and insurance companies in BCRC recoveryprocesses;
  • Handles incoming phone calls & outbound calls on inquiries forbeneficiaries, attorneys, & insurance companies;
  • Health insurance experience, 16 years;
  • Health plans, 16 years;
  • Medical laws, 16 years;
  • Healthcare laws, 16 years
  • Medical coding, 16 years;
  • Julianne Luong-Willingham - page 1
  • Medical documentation & research, 16 years
  • Legal Writing

University of Oklahoma
09.2019 - 12.2022
  • Years 4 months)
  • Graduate Work Project- Anti-Kickback Violations, False Claims, Stark Law, Exclusion, CMPL;
  • Demonstrated strong organizational and time management skills while managing multiple projects
  • Developed strong organizational and communication skills through coursework and volunteer activities
  • Gained extensive knowledge in data entry, analysis, and reporting
  • Used critical thinking to break down problems, evaluate solutions and make decisions
  • Demonstrated leadership skills in managing projects from concept to completion
  • Demonstrated strong organizational and time management skills while managing multiple projects;
  • Knowledgable with Equal Employment Opportunity Commission (EEOC)
  • Knowledge of fraud statutes and regulations, federal guidelines;
  • Legal research ( 2 years)
  • Experience with healthcare laws
  • Experience with medical & malpractice laws

Education

Master of Science - Healthcare Law

University of Oklahoma

Bachelor of Arts - Lifespan Healthcare Administration

University of Oklahoma

Certified Professional Compliance Officer (CPCO) - AAPC -

AAPC
Salt Lake City, UT
05.2023 - 05.2023

Certified HIPAA Awareness For Business Associates - HIPAATraining.com -

HIPAATraining.com
Austin, Tx
01.2023 - 01.2025

Certified HIPAA Security - HIPAATraining.com -

HIAATraining.com
Austin
01.2023 - 01.2025

Skills

Collaborative leadership, effective verbal & written communication;undefined

Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline

Certified Professional Compliance Officer (CPCO) - AAPC -

AAPC
05.2023 - 05.2023

Certified HIPAA Awareness For Business Associates - HIPAATraining.com -

HIPAATraining.com
01.2023 - 01.2025

Certified HIPAA Security - HIPAATraining.com -

HIAATraining.com
01.2023 - 01.2025

University of Oklahoma
09.2019 - 12.2022

MSP Medicare Recovery QA Specialist II

Chickasaw Nation Industries, Inc
04.2007 - Current

Master of Science - Healthcare Law

University of Oklahoma

Bachelor of Arts - Lifespan Healthcare Administration

University of Oklahoma
Julianne Luong-WillinghamMSP Medicare Recovery QA Specialist