Megan Cichocki
Perrysburg,Ohio
Summary
Dynamic and results-driven healthcare professional with exceptional leadership skills and a proven track record of spearheading impactful initiatives that enhance provider and member experiences. Expertise in leading cross-functional teams, managing complex projects, and implementing innovative solutions to optimize healthcare delivery and operational efficiency. Committed to fostering a culture of excellence, collaboration, and continuous improvement to ensure the highest quality of care and service. Recognized for cultivating strong stakeholder relationships, achieving measurable outcomes, and championing transformative improvements across the healthcare landscape.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Supervisor, Provider Appeals
Paramount Healthcare
05.2023 - 10.2024
- Evaluated staff performance and provided coaching to address inefficiencies.
- Maintained strong attention to detail while reviewing numerous medical documents daily, ensuring consistent quality and accuracy.
- Maintained strict confidentiality with sensitive client information, adhering to industry standards and company policies.
- Reduced turnaround time for reviews by effectively prioritizing tasks and managing deadlines.
- Ensured consistency across multiple review projects by maintaining strict adherence to established protocols and procedures.
- Stayed up-to-date on industry trends and best practices, incorporating relevant information into reviews as needed.
- Improved team productivity by streamlining document review processes.
- Managed high volumes of medical record reviews with strict deadlines, consistently maintaining a high level of accuracy and attention to detail.
- Reviewed charts and flagged incomplete or inaccurate information.
Supervisor, Document Entry and Workflow
Paramount Healthcare
08.2022 - 10.2024
- Oversaw daily operations of the department, ensuring smooth workflow and timely completion of tasks.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Increased team productivity by implementing efficient workflows and setting clear expectations for staff members.
- Collaborated with other departments to achieve organizational goals, fostering teamwork across various functions.
- Conducted performance evaluations for staff members, identifying areas of improvement and guiding professional development plans.
- Identified operational inefficiencies and implemented corrective measures to increase effectiveness.
- Enhanced team productivity by streamlining workflow processes and implementing efficient scheduling systems.
- Enhanced operational workflow, identifying and eliminating bottlenecks in daily procedures.
- Achieved significant improvements in operational efficiency, introducing and enforcing quality control measures.
- Collaborated with cross-functional teams to test and implement new systems and software updates, improving overall performance and efficiency
Supervisor, Claims Quality Assurance
Paramount Healthcare
08.2022 - 04.2023
- Developed comprehensive training program for new hires, significantly reducing learning curve and integrating them into team quickly.
- Led successful project completions under tight deadlines, coordinating effectively across multiple teams.
- Fostered culture of continuous improvement, encouraging team to suggest and implement process enhancements.
- Developed effective improvement plans in alignment with goals and specifications.
- Helped meet changing demands by recommending improvements to business systems or procedures.
- Conducted training sessions for new Claims Auditors, sharing best practices and fostering professional development.
- Provided valuable insights from audit findings to senior management for strategic decision-making purposes regarding operational improvements or risk mitigation efforts.
- Prioritized daily tasks to satisfy workload demands and department's turnaround goals.
- Enhanced claim accuracy by meticulously reviewing and auditing claim submissions.
- Assisted in recovering funds through diligent identification of overpaid or incorrectly paid claims.
- Collaborated with claims adjusters, ensuring proper investigation and resolution of complex cases.
- Served as a subject matter expert within the Claims Auditor team, offering guidance when needed to support overall team effectiveness.
- Contributed to departmental goals by consistently meeting or exceeding personal audit targets and deadlines.
Claims Project Coordinator
Paramount Healthcare
12.2021 - 08.2022
- Supported management's decision-making process by providing insightful reports analyzing historical claims data.
- Served as an expert resource for colleagues on medical coding systems such as ICD-10, CPT, and HCPCS Level II coding conventions.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Identified and resolved discrepancies between patient information and claims data.
- Utilized data-driven root cause analysis to resolve systemic claim issues, enhancing AR recovery and provider payment efficiency
Medical Billing and Coding Specialist
Advantage Billing and Cash Flow Solutions, Inc.
05.2016 - 08.2018
- Reviewed operative notes in order to ensure proper coding for billing purposes
- Held complete responsibility for billing numerous large accounts
- Managed the credentialing and recredentialing process for providers when becoming participants with insurance companies
- Created and submitted prior authorizations to insurance companies
- Billed a variety of specialties including Podiatry, Home Health Care, Durable Medical Equipment, Surgery, Urgent Care and Family Practice
- Highly involved in all aspects of the medical billing cycle
- Communicated with providers, office staff, patients, and insurance companies from across the country on a daily basis
Provider Inquiry Representative
Paramount Healthcare
08.2018 - Current
- Manage secure messaging on MyParamount portal as department lead
- Support coworkers in navigating MyParamount portal to better assist and educate providers
- Coordinate with IT to resolve requests for assistance within MyParamount portal
- Represent department in Axiom/Transshuttle provider registration as designated point of contact
- Troubleshoot provider issues within Axiom/Transshuttle to ensure proper claim submission
- Communicate status of various projects as departmental representative in monthly Provider Relations/Provider Inquiry operations meetings
- Facilitate effective two-way communication with providers across multiple platforms
- Record and distribute all meeting minutes to entire department
- Conduct staging of current and future portal to prepare for new portal go-live
Supervisor, Provider Relations
Medical Mutual
10.2024 - Current
- Enhanced communication within the team by holding regular meetings and encouraging open dialogue among all members.
- Demonstrated commitment to the organization''s core values, leading by example and fostering a culture of excellence.
- Conducted thorough employee evaluations to identify areas for growth and development, leading to more skilled workforce.
- Managed diverse team, promoting inclusive work environment that leveraged individual strengths.
- Educated staff on organizational mission and goals to help employees achieve success.
- Collaborated with other departments to achieve organizational goals, fostering teamwork across various functions.
- Increased efficiency by implementing improved processes for routine tasks related to provider engagement.
- Collaborated with cross-functional teams to resolve complex provider issues, resulting in improved provider relations.
- Identified opportunities for process improvement within the provider relations department, implementing changes that led to increased efficiency and cost savings.
- Analyzed data from various sources to identify trends, anticipate future needs, and inform strategic planning efforts related to provider relations.
- Enhanced provider relations by addressing inquiries and resolving issues in a timely manner.
- Developed standard operating procedures for the provider relations department, leading to increased efficiency and consistency across all functions.
- Strengthened provider relations by organizing and conducting regular meetings to address concerns and discuss improvements.
- Promoted a culture of continuous improvement within the provider relations team, regularly soliciting feedback from healthcare providers and incorporating suggestions into strategic plans.
- Fostered strong relationships with local healthcare providers, enabling seamless coordination of services as needed to support residents'' wellbeing.
- Developed positive relationships with medical providers and repair facilities to facilitate efficient communication during the claims process.
- Developed strong relationships with local healthcare providers, facilitating effective communication to improve patient care.
- Developed strong relationships with providers, fostering open communication channels for more efficient resolution of claim disputes.
- Developed strong relationships with healthcare providers, fostering a positive working environment and enhancing collaboration efforts.
- Developed and maintained positive relationships with external partners such as insurance providers, vendors, and community organizations in support of key departmental objectives.
- Developed strong relationships with healthcare providers, improving communication and fostering collaborative patient care efforts.
- Developed and maintained good rapport and cooperative working relationships with providers, staff and patients.
- Developed strong relationships with healthcare providers to ensure broad network of specialists for patient referrals.
- Established strong relationships with local healthcare providers, improving referral rates and expanding the practice''s network of resources.
- Strengthened relationships with healthcare providers through proactive outreach efforts aimed at improving communication channels.
- Fostered strong relationships with healthcare providers and insurance representatives to facilitate efficient resolution of billing issues.
Education
Certified Billing and Coding Specialist -
National Health Career Organization
04.2017
Medical Billing & Coding - Health Administration
Stautzenberger College
Maumee, Ohio05.2016
Skills
- Experienced in coding and billing across CPT, HCPCS, and ICD-10-CM systems
- Familiar with Medicare and Medicaid guidelines
- Provider relations
- Prospect relationship building
- Organization and time management
Certification
- CBCS - Certified Billing and Coding Specialist
Timeline
Supervisor, Provider Relations
Medical Mutual
10.2024 - Current
Supervisor, Provider Appeals
Paramount Healthcare
05.2023 - 10.2024
Supervisor, Document Entry and Workflow
Paramount Healthcare
08.2022 - 10.2024
Supervisor, Claims Quality Assurance
Paramount Healthcare
08.2022 - 04.2023
Claims Project Coordinator
Paramount Healthcare
12.2021 - 08.2022
Provider Inquiry Representative
Paramount Healthcare
08.2018 - Current
Medical Billing and Coding Specialist
Advantage Billing and Cash Flow Solutions, Inc.
05.2016 - 08.2018
Certified Billing and Coding Specialist -
National Health Career Organization
Medical Billing & Coding - Health Administration
Stautzenberger College
Awards
- 2024 - Selected to participate in Supervisor Cohort Leadership Program
- 2024 - Nominated and selected as the recipient of the Difference Maker Award for excellence in leadership, process improvement and exceptional performance
- 2023 - Appointed as member of the Service of Excellence Committee, focused on HMO/Marketplace member satisfaction
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