Linda Harvey
Warwick,USA
Summary
Insurance services manager with a proven track record at R1 RCM, excelling in operations management and staff development. Expert in claims resolution and contract management, I successfully implemented process improvements that enhanced workflow efficiency. Adept at client communication, I foster team motivation and drive performance to achieve organizational goals.
Overview
21
21
years of professional experience
Work History
Manager Insurance Services
R1 Rcm
Fort Washington, USA
11.2021 - Current
- Manage and review complex claims issues to determine the best outcome and obtain supporting documentation as required for validation or account resolution.
- Train, mentor, motivate, and oversee staff performance, including coaching when needed.
- Identify process improvements, develop, and implement workflow changes to improve operational service and production efforts, and to streamline operations.
- Manage daily operations and processes within the department by monitoring employee workflow, production, quality, inventory, and distribution of work assignments
- Monitor compliance with all departmental policies, procedures, and workflows, as well as processing timelines established through department service level targets (SLTs).
- Monitor departmental and individual performance metrics, and take proactive action when necessary, on a timely basis, to maintain desired workflow output, acting upon variances when applicable.
- Cross-trained staff in secondary roles to expand operational diversity
- Organized training for new team members, and routine retraining for established employees.
- Facilitated team meetings, and provided constructive feedback.
- Oversaw employee recruitment, training, and onboarding processes.
Supervisor Insurance Operations
Acclara Solutions
Fort Washington, USA
10.2015 - 11.2021
- Attended and contributed to regular managerial meetings
- Led weekly team meetings to discuss updates, progress, and to address any concerns or issues.
- Managed and reviewed complex claims or issues to determine the best outcome.
- Oversaw insurance provider representative agendas in all client and carrier claims disputes
- Train, mentor, motivate, and oversee staff performance, including coaching when needed.
- Supervised and guided employees to reach individual and team goals
Contract Payment Analyst
St. Luke's University Health Network
Bethlehem, USA
01.2004 - 06.2015
- Identified patterns of underpayments by using careful analysis and auditing of insurance contracts.
- Researched and analyzed insurance contracts to verify current updates, and ensure the accurate pricing of claims.
- Coordinated and communicated with billing staff to provide information about implemented changes to the insurance rates.
- Identified underpayments, compiled projects, and coordinated with provider representatives to resolve processing errors and recover underpayments.
- Negotiated settlements on delinquent accounts within company guidelines
Education
Associate in Applied Science (A.A.S.) - Business Administration
Allentown Business School
Allentown, PASkills
- EPIC System
- Microsoft Excel
- Staff Development
- Operations Management
- Client Communication
- Contract Management
- Claims Specialist
- Grievance and Appeals Specialist
Timeline
Manager Insurance Services
R1 Rcm
11.2021 - Current
Supervisor Insurance Operations
Acclara Solutions
10.2015 - 11.2021
Contract Payment Analyst
St. Luke's University Health Network
01.2004 - 06.2015
Associate in Applied Science (A.A.S.) - Business Administration
Allentown Business School
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