Karen Valandra
Newburgh,IN
Summary
Highly motivated, dedicated, and accomplished healthcare professional with extensive experience in healthcare services coordination, operations supervision, Medicare, Medicaid, Commercial Insurance and financial management. Equipped with outstanding interpersonal communication skills to liaise and collaborate within all levels of the organization. A dynamic leader and collaborative team player with the ability to streamline daily operations and processes through work organization, time management, and process enhancement. With a proven track record of solid work ethic, accountability, professionalism, and integrity to deliver top-notch services and promote organizational success.
Overview
39
39
years of professional experience
Work History
Insurance Specialist SR for Affiliated Oncologists
US Oncology Network
EVANSVILLE IN
11.2023 - Current
- Processed insurance claims efficiently, ensuring compliance with industry regulations.
- Collaborated with healthcare providers to verify patient insurance eligibility and benefits.
- Analyzed claim discrepancies, identifying root causes and implementing corrective actions.
- Followed up on denials, late payments, extensions and other special circumstances.
- Tracked pending authorizations to resolve discrepancies and avoid revenue loss.
- Maintained high standards of customer service by building relationships with clients.
- Communicated effectively with members of operations, finance, and clinical departments.
- Researched and resolved routine and complex issues.
- Contributed to team performance by sharing industry knowledge and assisting colleagues in complex cases.
- Maintained confidentiality of patient finances, records, and health statuses.
- Performs all other duties as assigned.
Travelling Business Office Manager
Quorum Business Solutions – Wilbarger General Hospital
Vernon, TX
02.2022 - 05.2022
- Directed the hiring and onboarding of 12 remote employees while training them to become proficient billers, collectors, and posters.
- Administrated various processes, including managing the hospital’s revenue cycle while ensuring efficient daily operations.
- Established robust relationships, collaborations, and partnerships while directly reporting to the hospital’s CEO and CFO.
- Provided outstanding leadership and management while maintaining a conducive and productive work environment.
Business Office Manager
Riverview Surgery Center
Rockport, IN
07.2021 - 10.2021
- Facilitated all aspects of the center’s business office operations, including monthly reconciliations with the German American Bank.
- Oversaw the center’s account payables and account receivable while maintaining updated and accurate QuickBooks.
- Demonstrated keen attention to detail and work organization by encoding numerous vendor invoices and cut checks weekly.
- Directed the payroll and monthly physician distribution while providing month-end closing reports to the Executive Director.
Business Office Manager
American Senior Care/Columbia Healthcare
Evansville, IN
09.2018 - 06.2021
- Administrated daily financial operations, including accounts payable, accounts receivable, payroll, and resident trust, while streamlining the processing and statement transmission for all Medicare, Medicaid, Insurance, VA, Hospice, and Private pay.
- Proactively collaborated with the Admitting Director in managing referrals and new admissions for long-term and short-term care.
- Conducted month-end billing and closing procedures while collecting all amounts and maintaining aging under 90 days.
- Created daily census and reported to the management team regarding new admissions, individualized care plans, and discharges.
Director of Patient Financial Services and Access/ Contract Compliance Director/ HIPAA Privacy Officer/ACO Champion
Perry County Memorial Hospital
Tell City, IN
08.2007 - 05.2017
- Directed all aspects of contract agreements with commercial insurance while managing care organizations, HMOs, PPOs, Medicare Advantage Programs, IN and KY Medicaid and their MCOs, ancillary departments, and market exchange plans.
- Managed and ensured the compliance of contract agreements while directly reporting to the CFO and CEO of KatzBrunner Healthcare.
- Boosted daily operations by utilizing a master spreadsheet for the hospital and 6 clinics owned by PCMH, consequently streamlining the enrollment and credentialing process of physicians and NPIs and renewing licenses.
- Oversaw all EO and bad debt transactions while monitoring monthly collection activity and providing support to the financial counselor.
Supervisor
Deaconess Hospital
Evansville, IN
06.2004 - 08.2006
Group Leader /Supervisor
Consolidate Health Services/American Nursing Care
Milford, OH
03.1998 - 03.2004
Billing Coordinator
PartnersFirst Management/ Olsten Kimberly Quality
Orlando, FL
03.1990 - 12.1997
Medical Record Clerk/Correspondence Secretary/PAR
Welborn Baptist Hospital
Evansville, IN
06.1987 - 05.1988
Education
Bachelor of Arts -
University of Southern Indiana
Evansville, INSkills
- Medicare
- Commercial Insurance
- Revenue Cycle Management
- Accounts Receivable
- Project Management
- Healthcare Coordination
- HIPAA
- Credentialing
- Revalidation & License Renewal
- IN DSH Audits/WPS Audits
- Financial Management
- Operations Supervision
- Compliance Management
- AIDET/HEAT QUINT STUDER
- CMS/WPS
- IHCP/DFR
- Care Management
- Health System
- Marketing
- Contract Management
- People Management
- Customer Satisfaction
- Data Analysis
- Contract Negotiation
- Project Documentation
- Innovation
- Leadership & Collaboration
- Cost-Effective Strategies
- Adaptable
- High Performer
Timeline
Insurance Specialist SR for Affiliated Oncologists
US Oncology Network
11.2023 - Current
Travelling Business Office Manager
Quorum Business Solutions – Wilbarger General Hospital
02.2022 - 05.2022
Business Office Manager
Riverview Surgery Center
07.2021 - 10.2021
Business Office Manager
American Senior Care/Columbia Healthcare
09.2018 - 06.2021
Director of Patient Financial Services and Access/ Contract Compliance Director/ HIPAA Privacy Officer/ACO Champion
Perry County Memorial Hospital
08.2007 - 05.2017
Supervisor
Deaconess Hospital
06.2004 - 08.2006
Group Leader /Supervisor
Consolidate Health Services/American Nursing Care
03.1998 - 03.2004
Billing Coordinator
PartnersFirst Management/ Olsten Kimberly Quality
03.1990 - 12.1997
Medical Record Clerk/Correspondence Secretary/PAR
Welborn Baptist Hospital
06.1987 - 05.1988
Bachelor of Arts -
University of Southern Indiana
Leadership And Other Activities
- Host – NRACO Caravan Health
- Member – Healthcare Financial Management Association
- Host – U.S.I. Internship Programs
Computer And Technical Skills
- Athena IDX
- Centricity G4
- I KNOW MED
- EPIC
- MOSIAQ
- Microsoft Office Suite (Word, Excel, PowerPoint, Outlook)
- Availity
- NGS/WPS and Palmetto GBA
- IL and IN Medicaid
- UHC, UMR, AETNA, CIGNA Portals
- Optum EncoderPro
- HMS/MedHost
- RelayHealth
- EPremis
- Ahi
- Invision/Siemens
- CPSI
- Quadax