Summary
Overview
Work History
Education
Skills
Certification
References
Timeline
Generic

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, WI

Skills

  • 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

Bachelor of Arts - Social Work

University of Wisconsin - River Falls

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Rachel Schmidt