Rachel Schmidt
Eden Prairie,MN
Summary
Motivated and experienced Clinical Auditor, excellent at juggling multiple tasks and working under pressure. Proven expertise in conducting in-depth audits and devising improvement strategies.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Clinical Auditor
illumifin
Eden Prairie, MN
06.2014 - Current
- Perform audits to review procedural and financial accuracy of decision makers, to ensure compliance with internal Practice Standards, Training Bulletins, and client-specific directive.
- Write client reports summarizing monthly audit findings and mitigation plans to improve audit scores.
- Provide follow-up with supervisors to ensure errors are addressed and corrected by decision makers.
- Present audit results to assigned teams in non-technical terms for easy understanding.
- Train new, veteran, and performance management decision team members, typically 3-6 months, to the standards of the company.
- Train audit team members on client-specific information and provide corrections of their audit reviews prior to working with trainees.
- Complete 'audit the auditor' reviews to ensure audits were consistent across auditors and clients.
- Work closely with management to discuss trainees, audit results, and audit corrections, including leading a weekly meeting with management and auditors.
Care Manager 2
Long Term Care Group (illumifin)
Eden Prairie , MN
06.2007 - 08.2014
- Reviewed long-term care policies, provider records, and medical records to determine the policyholder's eligibility for long-term care benefits.
- Completed communication to policyholders through letters and approval or denial calls.
- Completed contestable and misrepresentation claims reviews by reviewing policyholder applications and medical records, summarizing findings, and sending recommendations to the Medical Director.
Education
Bachelor of Arts - Social Work
University of Wisconsin - River Falls
River Falls, WISkills
- Compliance standards
- Excellent written communication
- Self-motivated
- Report Writing
- Team work
- Staff development
- Outstanding organization
Certification
- Licensed Social Worker
References
References available upon request.
Timeline
Clinical Auditor
illumifin
06.2014 - Current
Care Manager 2
Long Term Care Group (illumifin)
06.2007 - 08.2014
- Licensed Social Worker
Bachelor of Arts - Social Work
University of Wisconsin - River Falls
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