Kathy DUKE
WEST VALLEY,UT
Summary
Energetic Supervisor successful at motivating and building positive team dynamics to accomplish aggressive goals. Practical problem-solver with excellent issue and conflict resolution skills to drive team and organizational success. Highly effective and knowledgeable in provider configuration and claims processing.
Overview
28
28
years of professional experience
Work History
Provider Operations Calibration Supervisor
Select Health
07.2021 - Current
- Oversaw daily operations of both on shore and off shore team, ensuring smooth workflow and timely completion of tasks.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Collaborated with other departments to achieve organizational goals, fostering teamwork across multiple teams.
- Mentored caregivers in their career development, sharing knowledge from years of experience in the field.
- Cultivated strong relationships with other departments through consistent communication.
- Devised and implemented processes and procedures to streamline operations.
Senior Configuration Analyst
Select Health
05.2016 - 06.2021
- Conducted thorough audits of existing configurations to identify areas for improvement and implement corrective actions accordingly.
- Designed custom reports using data analysis tools to provide actionable insights into configuration activities and trends, guiding strategic decision making.
- Led teams of analysts to identify configuration discrepancies, resolving issues promptly and minimizing project delays.
Data Mining
DataMetrix
06.2013 - 05.2015
- Completed comparisons of provider contracts to claims for identifying under and overpayments.
- Streamlined data collection processes for increased efficiency and accuracy in data mining tasks.
Claims Processor
ACS/Blue Cross And Blue Shield
01.1996 - 06.2013
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Reviewed applications and supporting documents to verify claims eligibility and accuracy.
- Managed workload and priorities to meet claims processing meet deadlines.
Education
AAPC Certifications
Skills
- Training and mentoring
- Goal-Oriented
- Complex Problem-Solving
- Strategic Planning
- Staff Discipline
- Analytical Thinking
- Process Analysis
- Audit reporting
- Provider Configuration
- Detail Oriented
- Willing to Learn
- Leader
Timeline
Provider Operations Calibration Supervisor
Select Health
07.2021 - Current
Senior Configuration Analyst
Select Health
05.2016 - 06.2021
Data Mining
DataMetrix
06.2013 - 05.2015
Claims Processor
ACS/Blue Cross And Blue Shield
01.1996 - 06.2013
AAPC Certifications
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