Thuyhanh Nguyen
Manager, Reimbursement
Sacramento,CA
Summary
Experienced Manager with 25+ years Health Care experiences. Possess exceptional work ethic and desire to go above and beyond to exceed company expectations. Excel in fast-paced, deadline-driven environments to manage goals and team development. History of thriving in team-oriented environments.
Overview
24
24
years of professional experience
Work History
Manager, Reimbursement
Optum360
02.2015 - 12.2023
- Lead, and manage a team of 16 analysts on maintenance of Payment Integrity Compass reimbursement system for both Government and contracted Managed Care payers for 36 Dignity Health facilities.
- Implemented Payment Integrity Compass (PIC) reimbursement system. Validated data and contract set up to ensure the accuracy of reimbursement calculation per negotiated contract.
- Identifies denial and underpayment trends, implement processes and policies to reduce denials and increase recoveries. Identified $74M and recovered $30M for the first 3 quarters of fiscal year 2022.
- Provide Payer's scorecard and issues to Payer Strategy Relation (Managed Care) team to assist with contract negotiation.
- Lead contact for Payer Settlements reimbursement pricing and individual Letter of Agreement
- Maintain annual employee satisfaction survey score above 85% for more than 5 years in a row.
Sr Financial Analyst
Optum360
12.2013 - 02.2015
- Lead Senior Financial Analyst reporting directly to Senior Operation Director.
- Produce weekly, monthly, quarterly, yearly AR financial reports and presentation to Senior Leadership. Highlighting problem AR area with a recommendation for resolution
- Provide Adhoc AR report as requested by various Department
- Provide detail AR analysis for various department as needed.
Underpayment Reimbursement Analyst
Dignity Health Sacramento
05.2005 - 12.2013
- Reviewed accounts against signed managed care contract to identify underpayments.
- Provide detailed calculation to each account to assist collection team on appeal and recovery of underpayment
- Verified reimbursement questions for providers, billing and coding staff.
- Worked with billing department to reduce contract implementation errors.
- Precisely calculated refunds, premiums, and adjustments.
Cashier/Customer Service Representative
Catholic Healthcare West
09.1999 - 05.2005
- First line of contact for patient customer service inquiry onsite at hospital. Provide resolution or escalate to appropriate team to assistant.
- Operated cash register, collected payments, and provided accurate change.
- Manual daily cash from lockbox for 4 facilities
- Reconcile daily, monthly against bank deposit.
Education
Bachelor of Science - Environmental Science
San Jose State University
San Jose, CA06-1998
Skills
Proficiency in Microsoft Office suite, Word, Excel, Powerpoint, Access
Effective communication, soft skills and prioritization of assignments
High knowledge/skills with Payment Integrity Compass and MedSeries 4 systems
Staff Development
Complex Problem Solving
Performance Evaluations
New Policies Processing
Employee Coaching and Motivation
Timeline
Manager, Reimbursement
Optum360
02.2015 - 12.2023
Sr Financial Analyst
Optum360
12.2013 - 02.2015
Underpayment Reimbursement Analyst
Dignity Health Sacramento
05.2005 - 12.2013
Cashier/Customer Service Representative
Catholic Healthcare West
09.1999 - 05.2005
Bachelor of Science - Environmental Science
San Jose State University