Philomena Kline

• · Monthly HMO (till 3/2023) / HRP Training calls
• Create agenda, PowerPoint presentation, and calibration questions.
• o Compile all individual calibration quiz results as well as attendance for training calls forwarded reporting on auditor KPM sheets.
• § Information is maintained on a running monthly excel document for easy access for all supervisors.
• o Facilitate monthly HRP Training Calls.
• · New Hire Auditor Training / Existing Auditor Cross-Training (Beginning 03/2023-present)
• o Responsible for New Hire HRP Prepay training as well as cross-training existing auditors to different platforms (Prepay/Post-pay/Stratified audits)
• o 100% Review for all auditors who go through training.
• § 15 HRP Prepay Training Classes (25 Auditors Trained)
• § 4 HRP Post-pay Training Classes (17 Auditors Trained)
• § 1 HRP Post-pay Cross-Training Class (8 Auditors Trained)
• § 1 HRP Stratified Cross-Training Class (6 Auditors Trained)
• · HRP Pulls
• o Currently on a rotation as a primary handler and backup handler for daily/hourly/weekend pulls.
• o HRP Post-pay replacements.
• · Inventory and Production Reporting
• o Presentation of AM/PM inventory and production
• o Complete auditor workplan assignments for next business day
• o Monday / Friday inventory for Concentrix and Sagility calls
• · Daily Responsibilities as required.
• o HRP Workflow Mailbox
• o Assignment of high dollar claims to reduce backlog volume.
• o QAPO Auditor production/attendance remediations and follow-up to verify completions.
• o Continuous Education emails for incomplete audits.
• o Work with Auditors to get high dollar and aged claims released.
• o Review and presentation of reaudits as well as updating the reaudit QuickBase log.
• o Backup for mentoring calls.
• Auditor Process Confirmations as necessary.
• 1:1 Coaching with Auditors as requested by TeamLead

• HMO / HRP Prepay/Post-Pay/Stratified Re-audit and Rebuttals
• Monthly HMO (08/2020 - 03/2023 / HRP Training Calls

o Create agenda, PowerPoint presentation, and calibration questions.

• Facilitated both HMO/HRP Training Calls
• Facilitated HMO mentoring calls
• Auditor Process Confirmations