Melissa Wagner
Harrison Township,MI
Summary
Dynamic DNFB Specialist with proven problem-solving expertise at Mclaren Macomb, adept at analyzing claims and enhancing billing accuracy. Successfully led cross-functional teams to resolve discrepancies, maintaining a DNFB Dashboard within optimal range. Skilled in claims analysis and effective time management, driving process improvements and fostering collaboration across departments.
Overview
7
7
years of professional experience
1
1
Certification
Work History
DNFB Specialist
Mclaren Macomb
10.2021 - Current
- Served as a liaison between clinical departments, finance, and administration.
- Complete Cerner reports to identify discharge not billed accounts for resolution.
- Assist departments with charge corrections.
- Run weekly meetings to discuss DNFB accounts and resolution.
- Coordinated with internal teams to resolve billing discrepancies efficiently.
- Train hospital departments on revenue cycle and discern resolution.
- Maintain DNFB Dashboard of 5.00-6.50
Utilization Review Specialist
Mclaren Macomb
10.2018 - 10.2021
- Analyzed claim denials to identify root causes and implement resolution strategies.
- Generated reports on denial trends, providing actionable insights for process improvement.
- Run veracity reports to track outstanding appeals and denials
- Communicate with payers on authorizations and denials
- Manage 30 plus incoming calls, emails, faxes per day from customers
- Attended Facility Denials Committee
- Manage 30 plus incoming calls, emails, faxes per day from customers
Skills
- Problem-solving expertise
- Claims analysis
- Billing and coding accuracy
- Collaborative team management
- Document organization
- IT skills
- Cross-functional teamwork
- Effective time management
- Problem-solving skills
Certification
COC- Certified Hospital Coder
CPC- Certified Professional Coder
CMB- Certified Medical Biller
Timeline
DNFB Specialist
Mclaren Macomb
10.2021 - Current
Utilization Review Specialist
Mclaren Macomb
10.2018 - 10.2021
Similar Profiles
Wendy CarlsonWendy Carlson
Pharmacy Technician at McLaren Health, McLaren Macomb HospitalPharmacy Technician at McLaren Health, McLaren Macomb Hospital
Jade MooreJade Moore
Registered Nurse at McLaren MacombRegistered Nurse at McLaren Macomb
Alexandra MolsonAlexandra Molson
Registered Nurse at McLaren MacombRegistered Nurse at McLaren Macomb
Marianne M. GrenierMarianne M. Grenier
Laboratory Phlebotomist at McLaren Port Huron HospitalLaboratory Phlebotomist at McLaren Port Huron Hospital
Lucy HoltzhouseLucy Holtzhouse
Commercial Lines Account Manager at The Salvati Insurance GroupCommercial Lines Account Manager at The Salvati Insurance Group