Linda Hagelgans
Falls City,USA
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. With over 25 years of experience in healthcare, auditing, customer service and provider experience, I am seeking a challenging position with growth potential to utilize those experiences to have a positive impact in your organization and serve as a valued resource.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Customer Service Associate
Lowe's
San Antonio, TX
03.2026 - Current
- Assist customers with product inquiries, enhancing overall satisfaction and loyalty.
- Maintain a high level of product knowledge, providing accurate information to customers.
- Resolve complaints efficiently, maintaining positive customer relationships.
- Process transactions accurately using point-of-sale systems to ensure seamless purchases.
- Monitor store displays for compliance with merchandising standards, optimizing product visibility.
HCP Commercial Auditor, Senior Service Operator
CGI USIS
09.2018 - 09.2024
- While working in a fully remote environment, I performed Outreach to providers requesting complete Medical Records or missing documentation not yet received that was needed for the Nurse Auditors/Coders by either fax, email or telephone calls to obtain the missing information for medical review audits.
- Handled confidential digital documentation and reporting.
- Managed the workload independently across different time zones.
- Managed the team’s productivity dashboard with Outreach worked, the gross pay, medical records received as well as the number of audits closed for Senior Management report weekly.
- Tagged medical records received from hospitals and facilities to simplify the process for Nurse Auditors/Coders reviewing for medical necessity and/or appropriate billing.
VA Audit Specialist, Senior Consultant
CGI Federal
02.2018 - 09.2018
- Re-price claims being sent for Demand of overpayment
- Work audits submitted by Providers for reconsideration
- QA of teams work for accuracy of pricing CPT and HCPC codes
- Created spreadsheets for Audit team with common codes used for pricing for each state
- Review medical records notating critical documentation for nurse review
Quality Assurance Supervisor, Commercial Repayment Center Project
CGI Federal
San Antonio, TX
03.2014 - 02.2018
- Supervise the Quality Assurance Team
- Generate letters and assign workload of new letters to be reviewed by QA Caseworkers.
- QA of Finance letters and Index department accuracy of incoming documentation.
- Prepare Key Performance Indicator reports for monthly distribution of accuracy to Senior Management and CMS.
- Created the Non-Group Health Plan letter dashboard to maintain records of over 1.1 million letters, valued in excess of $3.8B, member production and workload management.
- Manage Revenue Generating Letters/Variance report so Senior Management is aware of where we are with our monthly goals.
- Prepared daily executive level reports providing financial updates to Senior Management
- Compile data and prepare reports for presentation to high-level executives regarding workload.
- Collaborated with IT and BA’s daily to resolve QA related issues.
- Mentoring of new hires after completing training.
- Created Job Aids on how to audit letters based on requirements from Customer, CMS.
- QA of 125,000+ letters, valued over $494M in 2017.
- Assisted in integration testing and system enhancements with IT.
- Primary contact for Cigna when Caseworker/SME, working email and telephone inquiries within 24 hours.
- Brought attention to management of inappropriate billing by Insurer which allowed the CRC to collect almost $20,000 for CMS.
Education
Associates - Healthcare Management
Alamo Community College
03-2026
Associate of Applied Science Degree - Accounting Technology
St. Philips College
01-1994
Skills
- Accounting
- Quality Assurance/Quality Control
- Process Improvement
- Medical Coding/Billing
- Group/Non-Group Insurance
- Auditing Methodologies
- Medical Record Sorting
- Claims Processing
- Release of Information
- Leadership
- Health Care Insurance
- Medical Records
- Appeals
- Customer Service
- Microsoft Office Suite
- Excel
- Word
- Adobe Pro
Certification
- Certified Team Supervisor
- Project Management Essentials Certification (PMEC)
- ISO 9001:2008 Quality Management System Certified Internal Auditor
- Lean Six Sigma Yellow Belt
- HIPAA Certified
Timeline
Customer Service Associate
Lowe's
03.2026 - Current
HCP Commercial Auditor, Senior Service Operator
CGI USIS
09.2018 - 09.2024
VA Audit Specialist, Senior Consultant
CGI Federal
02.2018 - 09.2018
Quality Assurance Supervisor, Commercial Repayment Center Project
CGI Federal
03.2014 - 02.2018
Associate of Applied Science Degree - Accounting Technology
St. Philips College
Associates - Healthcare Management
Alamo Community College
SUMMARY OF QUALIFICATIONS
- Ability to maintain professionalism while working independently/remote.
- Extreme attention to detail.
- Excellent verbal and written communication as well as interpersonal skills.
- Excellent organizational, leadership, and interpersonal skills in customer service relations.
- Strong knowledge of HIGLAS (CMS Accounting system).
- Mitigate and resolve issues quickly; excels at conflict resolution
- Monitoring/Assessing performance of self, other individuals, and organizational processes to make corrective actions and implement process improvements.
- Establishing and monitoring productivity goals, while leading cross functional teams on key tasks and client deliverables
- Demonstrated ability of effective management and planning
- Adapt quickly to new challenges, possess tremendous problem solving abilities and the motivation to succeed