LORETTA WOLTER-PINKOWSKI

Representing over 22,000 members of labor unions,

• Maintained high standards of customer service by building relationships with clients.
• Analyzed customers' financial situations to recommend appropriate life insurance policies.
• Cultivated customer relationships to provide customized life insurance solutions tailored to individual needs.

Cash app in SAP. Daily mail prep; invoicing, receipt, and statement processing. The company was purchased by RWC Corp. Decision was made to consolidate locations, the Ontario warehouse was consolidated to Las Vegas.

• Communicated effectively with team members to deliver updates on project milestones and deadlines.
• Developed product documentation to communicate upcoming features and products to internal teams.
• Analyzed metrics to measure product performance.
• Equipped hospitals with the tools and information they need to obtain correct Medicare and Medicaid reimbursement.
• Position eliminated due to COVID-related business losses.

* Worked weekly with COO and facility managers where auditing 2012-2016 A/Rs identified and resolved payer and facility process issues.
Sovereign Healthcare Inc. operates as a management services company. It develops and operates surgery centers, offering practice services, such as full practice assessment/operational audit, managed care contracting, billing and collections, systems and information technology.

* Facility IP / OP Collections of Medicare HMOs & Medi-Cal HMOs A/R > 120 days.
* Data analysis & strong research skills demonstrated in appeals resulting in higher payments to facility.

* Assessed risk & improved performance by payer through audits where tracking trends resulted in recommendations to management and changes in the billing process.

* Reduced errors for more accurate & timely payments.

Managed Accounts Receivables for 9 client doctors: chiropractic, acupuncture, PT/OT.
* Increased reimbursement percentage; Reported A/R & practice analysis to clients monthly.
* Coded & Billed self-pay, group health insurance- PPO, IPA, EPO, HMO, Medicare, Medicaid.
* Aggressively pursued collection of liens, worked with attorneys, & represented clients as Hearing Representative.

* 40% of clients worked remotely-maintained excellent communication.

* Instructed 30 students per class: processed claims from medical offices & hospitals using CPT, ICD-9/ 10, HCPCS codes & Medical Terminology.

* Member American Academy of Professional Coders 2010-2015.

* Instruction in processing medical claims from doctors, medical offices, & hospitals.

* Billed Health plans, Medicare, Medical, HMO’s, & PPOs.

* Coded Claims using CPT, ICD-9/ 10, HCPCS codes.

* Taught Medical Terminology through PPT & lectures.

* Lab time in classrooms up to 30 students for 5-hour sessions both AM and PM.

*Collected, interpreted & evaluated referral data.

* Reporting responsibilities using Excel spreadsheets & graphs for COUM Manager.

* Familiar with mainframe, FilemakerPro, legacy systems, all MS Office products.

* Developed & documented clear policies & procedures for Systems Administrators.
* Successfully analyzed, resolved Y2K & programming issues to Foundation Benefits System.
* Developed in-service for claim routing issues & System Error Matrix.
* Trained additional Systems Administrators & Strike teams to resolve issues effectively.
* Provided In-house training to claims adjusters & indexing personnel in support of CAD supervisors.

* Provided support to Affiliated Contracts dept, Network Expansion Market, & outside Referral desk MSA's.

• Worked closely with Info System Dept as project specialist through JAD sessions.
• Analyzed complex claim issues, identified and then solved the problem.

* Worked to develop automated Medi-Cal claims processing & IV Pharmacy attachments, which increased reimbursement percentage of trailing 90-day A/R to best in the region from the worst. Also maintained the lowest >180 A/R in the region.
• Interpreted contracts for maximum reimbursement.
• Calculated government allowances. Monitored for government compliance.
• Screened high dollar claims for accurate adjudication.
• Hired, trained, managed Medicare & Medi-Cal IV A/R reps.
Infusion Division was closed in Fall 1998 due to poor contracts resulting in 281 pink slips. Apria re-opened Infusion Services in So California 2 years later.

* Cardiology insurance billing, payment posting & collections for multiple cardiologists.
* Collected 97% of past due payments ($75,000) from local IPA prior to their bankruptcy.
* Began Medical career in 1989 transferring analytical, budgeting, and purchasing skills/ leadership experience from a successful Retail Management career.