Nalina Brenzel

Dynamic Medicaid Consultant with a proven track record at Therap Services, excelling in client relationship management and strategic planning. Recognized for implementing process improvements that enhanced service delivery and increased customer satisfaction. Adept in data analytics and team leadership, driving successful project outcomes while fostering a culture of continuous improvement.

Experienced with delivering strategic consulting services to enhance client business operations. Utilizes in-depth industry knowledge and analytical skills to identify and implement effective solutions. Track record of building strong client relationships and driving measurable results.

Consulting professional with strong track record in delivering impactful business solutions. Adept at strategic planning, data analysis, and process improvement. Known for fostering team collaboration and adapting to evolving project needs. Brings expertise in client relations, problem-solving, and driving measurable results.

I am also an effective advisor communicates well with people of all ages and backgrounds. I am also have an Excellent eye for detail enabling quick identification of areas for improvement and suggesting strategies to help businesses reach goals. Focused on introducing efficient systems and processes.

I consider myself a forward-thinking Operations Specialist bringing 20+ years of expertise in the IDD services and CMS billing for Intellectual Disability sector of businesses. Cultivates rapport with individuals to optimize project goals and output, resolve complex problems and deliver innovative improvement strategies. Proficient in Microsoft, all office products, Therap software, SalesForce, All NC MCO portals, as well as HHA's portal, GAMMIS portal, Evergreen, Oracle, CIMOR portal, DEMMIS portal, as well as VA medicaid billing..

• Managed end-to-end billing cycle for an IDD service provider seeing 150+ patients weekly, ensuring timely Medicaid claim submission and follow-ups.
• Achieved a 98% clean claim acceptance rate for Medicaid submissions by implementing comprehensive pre-submission reviews specific to IDD documentation requirements.
• Resolved complex billing issues and managed the appeals process for denied Medicaid claims, successfully reversing denial decisions and securing revenue.
• Collaborated with healthcare providers and case managers to resolve IDD billing inquiries and discrepancies, improving payment recovery by 15%.
• Ensured all billing practices remained compliant with evolving state Medicaid and federal healthcare regulations (HIPAA).
• Processed over 2,000 medical claims monthly, including a high volume of Medicaid claims, maintaining a high accuracy rate.

I am also familiar with all, but not limited to the following:

The services provided through the NC Innovations Waiver are person-centered, meaning they are designed around the specific needs and choices of the individual, and include:

• Support at Home: Assistance with daily living tasks such as bathing, dressing, cooking, and budgeting. This can include Community Living and Supports in a family home or a person's own home, or Residential Supports in a licensed setting like a group home.
• Community Participation: Services to help individuals engage in community activities, such as classes, volunteering, or joining groups, through Community Living and Supports, Community Networking, or Day Supports programs.
• Employment Support: Supported Employment services, including job coaching, career counseling, resume preparation, and interview practice, to help individuals find and keep jobs in integrated work settings.
• Equipment and Modifications: Coverage for necessary items like assistive technology (communication devices, smart home tech), home modifications (ramps, wider doorways), and vehicle modifications (lifts, adapted controls) to enhance safety and independence.
• Crisis Services: 24/7 access to trained staff and psychologists to help prevent institutionalization or hospitalization during a crisis situation.
• Caregiver Support: Respite services offer scheduled or emergency short-term breaks for primary caregivers. Specialized Consultations and Natural Supports Education provide training and advice to caregivers on how to better support the individual.
• Moving to Your Own Home: Community Transition funds can cover one-time costs like security deposits and essential household items to help an individual move from a care facility to their own home.
• Care Management: All participants receive a Tailored Care Manager to help them navigate the services, find doctors, and serve as a main point of contact for all their health and support needs

• Collaborated with team of 30 in the development of EVV development and implantation of EVV for the state of GA, FL and NC. I have also worked in 15 states across the US and know the CMS guidelines for each state.
• Resolved product issue through consumer testing.
• Used Microsoft Excel to develop inventory tracking spreadsheets.
• Supervised team of 6 staff members as well as developed presentation and power points for all in person and virtual sessions.
• Increased team efficiency through continuous process improvements.
• Eliminated paperwork processing bottleneck, saving company time and money by implementing a EHR system that will keep all of the paperwork to a minimum.

• Certified in Excel as well as Adobe, Excel and Accounting.
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