Kristina Compagna
Augusta,ME
Summary
Highly trained professional with a background in verifying insurance benefits and creating appropriate patient documentation. An established Insurance Verification Specialist known for handling various office tasks with undeniable ease. Brings proven track record of success in determining eligibility and resolving complex cases. Works professionally with clients to develop and implement successful strategies for maximizing services and benefits. Skilled in problem-solving and identifying solutions meeting clients' needs.
Overview
31
31
years of professional experience
Work History
Public Assistance Eligibility Specialist
State Of Maine, Dept. Of Health & Human Services
11.2012 - Current
- Maintained up-to-date knowledge of federal, state, and local regulations governing public assistance programs to ensure compliance in all aspects of service delivery.
- Utilized advanced analytical skills to interpret complex financial information accurately, ensuring correct benefit calculations for eligible individuals.
- Managed caseloads efficiently while maintaining high-quality standards in decision-making processes throughout every stage from application to review as well as case maintenance. We no longer have a case load system, but go by pulling tasks in our assigned queue.
- Ensured data privacy compliance by adhering to strict confidentiality protocols when handling sensitive client information.
- Enhanced program integrity by diligently verifying accuracy of client information through various databases and third-party sources.
- Provided excellent customer service by addressing client inquiries professionally and compassionately, fostering trust between clients and agency.
- Identify potential fraud or errors that may have impacted benefit determinations and submit for overpayments and/or underpayments.
- Maintained a comprehensive working knowledge of all available resources within the community to provide accurate referrals for clients seeking additional support.
- Reduced processing time for applications by consistently meeting deadlines and prioritizing tasks effectively.
- Interviewed applicants and explained scope of different available benefits.
- Administered and tracked client service payments. Assisted cashiers office with returned State Supplement payments. This would include but not limited to updating or removing third party payee information. Reissuing State Supplement benefits onto EBT card.
- Improved client satisfaction with timely and thorough communication regarding their cases, including updates on application status.
- Participated in audits using Income Eligibility Verification Services (IEVS) Software. Audited information from Department of Labor, Social Security Administration and Department of Corrections.
Team Leader-Provider Services
Molina Healthcare
11.2011 - 11.2012
- Supervised team members to confirm compliance with set procedures and quality requirements.
- Monitored team performance and provided constructive feedback to increase productivity and maintain quality standards.
- Built strong relationships with customers through positive attitude and attentive response.
- Set performance expectations for the team, monitoring calls and providing constructive and positive feedback.
- Managed conflict resolution among team members, fostering a positive and collaborative work environment.
- Active member of the Employee Activity Committee sponsored by Molina Healthcare
Provider Services Representative
Molina Healthcare
10.2010 - 11.2011
- Coordinated with internal departments on behalf of providers to ensure timely payment resolution for claims disputes or other financial matters.
- Enhanced customer satisfaction by efficiently resolving provider inquiries and concerns.
- Streamlined operations by managing high volume of incoming calls for medical providers seeking information or assistance.
- Increased efficiency by accurately entering provider data into company systems and databases.
- Improved communication between providers and insurance companies, leading to better understanding of policy coverage and claim status.
- Educated providers on billing procedures, coding guidelines, and reimbursement policies for optimal claim submissions.
- Delivered prompt service to prioritize provider needs.
- Investigated and resolved customer inquiries and complaints quickly.
- Met customer call guidelines for service levels, handle time and productivity.
- Responded proactively and positively to rapid change.
Provider Services Representative (Acting Capacity)
State Of Maine, Dept. Of Health & Human Services
10.2007 - 10.2010
- Enhanced customer satisfaction by efficiently resolving provider inquiries and concerns.
- Coordinated with internal departments on behalf of providers to ensure timely payment resolution for claims disputes or other financial matters.
- Streamlined operations by managing high volume of incoming calls for medical providers seeking information or assistance.
- Acted as a liaison between providers and company leadership, effectively communicating concerns and feedback to facilitate continuous improvement initiatives.
- Increased efficiency by accurately entering provider data into company systems and databases.
- Educated providers on billing procedures, coding guidelines, and reimbursement policies for optimal claim submissions.
- Delivered prompt service to prioritize customer needs.
- Responded to customer requests, offering excellent support and tailored recommendations to address needs.
- Investigate and create spreadsheets for Provider Relations Specialists, to summarize history of submitted claims for providers who claims may have denied and need to be re-billed.
Cancer Registry Secretary
Maine General Medical Center
01.2005 - 09.2007
- Handled sensitive information discreetly, maintaining confidentiality when managing client files.
- Answered multi-line phone system.
- Scheduled Tumor Board bi-weekly luncheons and ordered provider meal.
- Prepared professional correspondence, including memos, letters, and emails, ensuring accuracy and timeliness.
- Maintained filing systems and categorized documents.
- Gathering patient information needed for bi-weekly Tumor Board meetings. Composed meeting minutes of specific cases that were to be discussed including provider recommendations and then distribute to specified physician offices of those clients.
- Worked closely with Chemotherapy Protocol Nurse by photocopying clinical trial information and updating manuals.
- Prepared and sent out surveys to both patients and providers asking about status of health following treatment. Example: 1, 5 and 10 year etc. post treatment
Customer Service Representative
Blue Cross And Blue Shield Of Maine
09.1996 - 11.1997
- Handled customer inquiries regarding benefit coverage, claim denial, and eligibility courteously and professionally.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputed claims.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Resolved customer complaints with empathy
- Answered constant flow of customer calls with minimal wait times.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Updated account information to maintain customer records.
- Completed a 12 week intensive training to gain knowledge in managed care, Medicare supplemental and traditional policies.
Medical Receptionist
Mercy Primary Care
09.1995 - 09.1996
- Coordinated patient scheduling, check-in, check-out and payments for billing.
- Checked patient insurance, demographic, and health history to keep information current.
- Helped patients complete necessary medical forms and documentation.
- Maintained strict confidentiality of patient information, adhering to HIPAA regulations and medical office policies.
- Ensured HIPAA compliance by maintaining strict confidentiality with all patient records and information.
- Managed a high volume of incoming calls, addressing inquiries, and providing exceptional customer service to patients.
- Organized paperwork such as charts and reports for office and patient needs.
- Handled financial transactions related to copayments or self-pay fees while adhering to company policies regarding payment collection.
- Coordinated appointment reminders for patients via phone calls reducing no-show rates.
- Greeted and interacted with patients to provide information, answer questions and assist with appointment scheduling.
- Managed multi-line phone system and pleasantly greeted patients.
- Provided administrative support to medical staff, assisting with various clerical tasks as needed.
- Expedited patient registration processes by gathering necessary paperwork from new arrivals promptly upon their arrival at the front desk.
- Transcribed phone messages and relayed to appropriate personnel.
- Performed various administrative tasks by filing, copying and faxing documents.
Unit Secretary
Mercy Hospital
06.1993 - 09.1995
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Managed incoming calls and directed to appropriate department.
- Maintained clean, organized work environment for optimal efficiency in delivery of patient care services.
- Contributed to positive patient experiences by greeting visitors, providing directions, and addressing inquiries professionally.
- Supported hospital compliance efforts by adhering to privacy policies and HIPAA regulations when handling sensitive patient information.
- Organized paperwork such as charts and reports for office and patient needs.
- Maintained rapport with physicians, nurses and other healthcare personnel.
- Assisted with training and onboarding of new unit secretaries, sharing expertise and best practices to ensure their success in the role.
- Improved unit workflow by effectively prioritizing tasks and collaborating with team members to complete assignments in timely manner.
- Managed inventory levels of office supplies, ensuring adequate stock was available at all times for efficient unit operations.
- Demonstrated flexibility in adjusting work hours to meet fluctuating demands of unit, ensuring coverage during both peak times and staff shortages.
- Maintained current and accurate medical records for patients.
- Enhanced patient care by efficiently managing medical records and promptly scheduling appointments.
- Order entry of doctors orders for lab, x-rays, physical therapy etc..
- Ordered patient education materials
- Scheduled appointments and maintained department master calendar for Outpatient Oncology Clinic
- Transport patients or specimens if needed
- Order patient lunches in Outpatient Oncology Clinic
Education
Some College (No Degree) - Medical Billing And Coding
Central Maine Community College
Auburn, MESkills
- Policy Interpretation
- Cross-cultural sensitivity
- Effective communication skills
- Documentation and paperwork
- Verbal Communication
- Medical Terminology
- Data Entry
- Interviewing
- Documentation And Reporting
- Medical Records Review
- Attention to Detail
- Maintaining Client Records
Competencies
Proficient in the following programs: IEVS, ACES, SIEBEL, QNXT, Healthpas, Avaya, CSME, Work Number, AVS, EPPIC, SAVE, Moses, Pulse, Streamline, Microsoft Office & Excel.
Timeline
Public Assistance Eligibility Specialist
State Of Maine, Dept. Of Health & Human Services
11.2012 - Current
Team Leader-Provider Services
Molina Healthcare
11.2011 - 11.2012
Provider Services Representative
Molina Healthcare
10.2010 - 11.2011
Provider Services Representative (Acting Capacity)
State Of Maine, Dept. Of Health & Human Services
10.2007 - 10.2010
Cancer Registry Secretary
Maine General Medical Center
01.2005 - 09.2007
Customer Service Representative
Blue Cross And Blue Shield Of Maine
09.1996 - 11.1997
Medical Receptionist
Mercy Primary Care
09.1995 - 09.1996
Unit Secretary
Mercy Hospital
06.1993 - 09.1995
Some College (No Degree) - Medical Billing And Coding
Central Maine Community College
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