Sandy Gunvalsen

Essential Duties and Responsibilities

• Resolve credit balances as assigned
• Create pdf outgoing correspondence
• Audit overseas vendor requests for refunds and correspondence to be sent
• Review payer refund requests, determine if appropriate, dispute or appeal if needed
• Identify payer trends causing credit balance and communicate to management
• Identify and correct payment posting errors/adjustments and communicate to management
• Receive and return calls/emails from payers and other departments
• Work with other departments problem solving and implementing solutions
• Other duties as assigned
• Reads and abides by the company’s code of conduct, ethics statements, employee handbook(s), policies and procedures and other corporate mandates, including participation in mandatory training programs
• Reports any real or suspected violation of the corporate compliance program, company policies and procedures, harassment, or other prohibited activities in accordance with the reporting policies of the company
• Obtains clarification of policy whenever necessary and may use the resources available through the Compliance, Human Resources or Legal Department to do so
• Support and abide by the values of the company
• Excellence– Going beyond to deliver the highest quality care and experience to our patients and teammates
• Collaboration– Being inclusive and supportive of one another to deliver improved outcomes to our patients and teammates
• Ethical Responsibility – Acting with the utmost integrity and doing the right thing, even when nobody is watching
• Engagement– Promote an environment where clinicians and teammates thrive, feel passion and joy for what they do, take care of each other, and are proud of who we are and what we do.

• Responsible for creating new databases.
• Routine generation of claims and statements.
• Monthly transfer and reconciliation of collection files with external collection agencies.
• Generation of reports for daily/weekly/monthly essential processes.
• Schedule end of month closes for all databases.
• Maintain and process company requests.
• Train and audit Offshore vendors
• Assist vendors with questions and requests monitor rejections.
• Troubleshoot issues with claims, GPMS, and eCommerce.
• Correspondence batching and scanning.
• Medical record reconciliation.
• Billed insurance claims; paper and electronic claim transmittal.
• Completed daily front end edits or rejections.
• Read and interpreted explanation of benefits.
• Handled unresolved claims for all insurance payers.
• Reconciled weekly/monthly payment reports- troubleshoots any discrepancies Researched missing insurance/personal payments.
• Processed refunds