Michael Perkins
Peoria,AZ
Summary
With 36 years of experience in the healthcare industry, I bring a wealth of expertise to contribute to a new team. Throughout my career, I have fostered unity among teams, resulting in improved outcomes and reduced inventory. My deep understanding of claim and benefit operations makes me a valuable asset to any organization.
Overview
41
41
years of professional experience
Work History
Manager – Business Systems Analysis
OPTUM
2020.01 - Current
- Support 13 analysts on timely system configuration and testing of CES claim editing payment rules tied to C&S Medicaid and DSNP plans
- Editing contributes to overall annual savings goal of $4.65B for United Community & State products
- Consistently meet 3-day TAT on tickets regarding payment questions, system set up
- Promote, support, and demonstrate collaborative engagement with business partners.
Manager – Data Mining Recovery Resolution
UnitedHealthcare
2016.01 - 2019.01
- $922m annual recovery goal across 25 Health Plans for Community & State lines of business
- Achieved departmental goals by developing and executing strategic plans and performance metrics.
- Liaison between Health Plans and business partner areas to drive resolution
- Liaison with outside vendor to assist with research and identification of overpaid claims
- 7 Direct reports – Interviewing, staff selection, performance management.
Manager - Claims
UnitedHealthcare
2003.01 - 2016
- Supervise 190+ staff members including 7 direct report Supervisors, in daily processing of medical claims
- Daily support including candidate selection, annual evaluations, problem resolution, information resource for staff and monitoring of production and quality
- Built high-performing teams through effective recruitment, onboarding, and talent development initiatives.
- Achieved departmental goals by developing and executing strategic plans and performance metrics.
- Manage inventory levels to goal of 4 days or less.
- Ensure state performance guarantee’s and interest reduction goals consistently met.
- Adapt departmental plans and priorities to address business and operational challenges
- Develop plans to meet short and long-term objectives
- Facilitate daily meetings with supervisors.
Manager – High Dollar Recovery Resolution
UnitedHealthcare
2012.01 - 2015.01
- 24 Direct reports – Interviewing, staff selection, performance management
- Oversee High Dollar review operations for Community and State lines of business
- Consistently exceed annual savings goals ($138mil for 2014) across 5 system platforms, representing 18 different health plans (states)
- Manage inventory levels and turnaround times to meet individual state performance guarantees
- Vital Signs Employee Engagement score of 91%. 2nd consecutive year over 90%
- Audit claims paying > 5k / 25k.
Claims Examiner, Support Analyst, Supervisor
UnitedHealthcare
1998.06 - 2003.01
- Process medical claims for multiple Medicaid and Medicare lines of business
- Research and test issues related to Claim processing system and Imaging system.
- Track progress
- Oversee and monitor daily operations; including scanning, data entry and rejected documents
- Set team direction, resolve problems, and provide guidance to members of team.
Assistant Manager
Walgreen’s
1997.06 - 1998.06
- Supervise and train employees with emphasis on customer service
- Worked with employees to improve production and quality of work
- Cash controls for daily operations
- Responsible for aesthetics of store and store inventory.
Senior Claim Analyst, Department Lead
Aetna
1983.12 - 1997.06
- Implementation of Tracking and Trending program used by Appeals department staff, leading to inventory reduction of pends down from over 8,000 claims to fewer than 1,000, with provider and processor education
- Perform quality control audits and provide management with reports of findings
- Resolved urgent and highly sensitive customer complaints and correspondence from state agencies, health care providers, Medicare beneficiaries and office management
- Conduct in-person, telephone and written reviews of beneficiary and provider claims
- Responsible for monthly preparation of state required reporting.
Education
AA – Business Administration -
Glendale Community College
Glendale01.1991
Skills
- Team Leadership
- Time Management
- Verbal and written communication
- Staff Management
- Operations Management
- Cross-Functional Teamwork
- Performance Management
- Staff Development
- Workforce Management
- Performance Evaluations
Activities
- Eagle Scout, Boy Scouts of America
- Volunteer Church Service, Ventura, CA, 1987 - 1989
Timeline
Manager – Business Systems Analysis
OPTUM
2020.01 - Current
Manager – Data Mining Recovery Resolution
UnitedHealthcare
2016.01 - 2019.01
Manager – High Dollar Recovery Resolution
UnitedHealthcare
2012.01 - 2015.01
Manager - Claims
UnitedHealthcare
2003.01 - 2016
Claims Examiner, Support Analyst, Supervisor
UnitedHealthcare
1998.06 - 2003.01
Assistant Manager
Walgreen’s
1997.06 - 1998.06
Senior Claim Analyst, Department Lead
Aetna
1983.12 - 1997.06
AA – Business Administration -
Glendale Community College
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