Michelle Dang
Westminster,CA
Summary
Proactive, forward thinking professional armed with an exemplary record of customer service to support corporate mission and business objectives. Excellent analytical, organizational, interpersonal, listening and communication skills. Reputation as a quick learner, who is a motivated self-starter dedicated to proficiency, hard work, organization, and reliability.
Overview
11
11
years of professional experience
Work History
Associate Project Manager
Vpls
07.2021 - 01.2022
- Supervised multiple projects from project start through delivery by prioritizing needs and delegating assignments.
- Coordinated cross-functional teams to ensure smooth execution of complex projects from inception to completion.
- Assisted with onboarding newly hired staff members and coached on task prioritization.
- Managed competing demands and professionally adapted to frequent change, delays and unexpected events.
- Actively participated in weekly project reviews with senior management to discuss progress updates, challenges faced, potential solutions, and future plans.
- Scheduled and facilitated meetings between project stakeholders to discuss deliverables, schedules and conflicts.
- Facilitated effective communication among team members by conducting regular meetings and promoting a collaborative working environment.
- Enabled accurate project tracking by maintaining up-to-date schedules, status reports, and budgets in project management software.
- Served as the primary point of contact for clients during the entire course of assigned projects, addressing concerns and providing updates on progress.
Claim Recovery Specialist
Advanced Medical Management Inc
09.2016 - 07.2021
- Review Capitation/Shared Risk audits using contracts and Division of Financial Responsibility (DOFR) to determine correct payment.
- Including all responsibilities mentioned in Recovery Assistant role.
Claims Recovery Assistant I/II
Advanced Medical Management Inc
09.2010 - 09.2014
- In charge with recovery of claims overpayments in high-volume operation.
- Manage accounts receivable functions including invoicing, processing payments, and following up on overdue accounts.
- Coordinate with all departments (Eligibility, Contracts, Claims, Provider Network, and Case Management) to resolve overpayment issues depending on reason for request.
- Worked independently with assigned medical groups and county programs recovering claims overpayments identified by various audit groups.
- Utilize the concepts of retro termination, provider deductions, general overpayments, check reconciliation, subrogation recoveries, stop payments, and returned checks to resolve problems.
- Review provider/ member/ health plan appeals, denials and disputes.
- Created new claims to offset overpayments from provider's future payments on Ez-Cap if/when reimbursement has not been received and/or if a response is not received by provider on a timely manner.
- Maintained detailed documentation on Ez-Cap and recovery tracking tool of overpayment progress, preparing weekly and monthly reports for management and medical group/ TPA Board Members.
- Handled County Program Third Party Liabilities and Subpoena with attorney office/ copy service companies.
- Perform all other job related duties and special projects as it relates to the job function or as delegated by the management.
- Post refund checks and check reconciliation bi-monthly.
- Created Policy and Procedure guidelines.
- Assisted credentialing dept to get requested documents such as w-9 and/or provider's termination documents.
- Trusted to train others act as a back-up person.
Education
Some College - Healthcare
Community College of Denver
Denver, CO2010
High School Diploma -
Orange Grove Education Center
Garden Grove, CA2006
Skills
- Organizer
- Multitasker
- Quality Customer Service
- Communication
- Problem Solver
- Adaptability
- HIPAA Compliance
- Knowledge in Onbase (Crystal Reports)
- Knowledge in Ez-Cap browser based administration software
- Knowledge in HIPAA
- Interpret explanation of payments and benefits
- Knowledge of Microsoft word, Excel, and Outlook
- Bilingual - English & Vietnamese
Timeline
Associate Project Manager
Vpls
07.2021 - 01.2022
Claim Recovery Specialist
Advanced Medical Management Inc
09.2016 - 07.2021
Claims Recovery Assistant I/II
Advanced Medical Management Inc
09.2010 - 09.2014
Some College - Healthcare
Community College of Denver
High School Diploma -
Orange Grove Education Center