Summary
Overview
Work History
Education
Skills
Timeline
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Valerie De Wijk

Seminole,FL

Summary

Driven professional with a background in healthcare compliance and policy interpretation, demonstrated at Lincare through the management of critical incidents and regulatory audits. Excelled in utilizing advanced research and precision to enhance patient eligibility verification at Organogenesis. Skilled in Microsoft Excel and effective communication, achieving increased accuracy and efficiency in high-stakes environments.

Overview

12
12
years of professional experience

Work History

Benefits Verification Specialist

Organogenesis
03.2020 - Current
  • Utilized advanced research skills to investigate specific policy provisions and resolve any ambiguities or conflicts.
  • Increased accuracy in verifying patient eligibility through diligent cross-checking of multiple databases before finalizing claim submissions.
  • Input received orders into company computer system to be filled by the warehouse.
  • Completed packing slips to be used by the warehouse
  • Contacted the Doctor's office as needed concerning order discrepancies and any issues.

Audit Analyst

Lincare
01.2012 - 10.2019
  • Processing Unusual Occurrences ranging from employee damages of a patient's property to house fires from patient's smoking with O2. Processing these incidents from stopping billing on the patient's damaged or destroyed equipment to filing insurance claims. This includes follow up on said incidents to make sure the centers have followed proper procedure.
  • Making sure all centers are aware of any product recalls. This usually involves medicinal recalls, but can cover equipment as well. Maintain a spreadsheet to show the all centers that carry the recalled products has been notified and the recalled product removed from inventory.
  • Created and maintained a spread sheet to show each regional vice president the incidents that took place in their perspective areas and the results of the incident.
  • Created and maintained various spreadsheets concerning incidents for various forms of treatment, from O2, DME equipment to infusion, IV treatments. Use of Microsoft Excel, Word and Outlook. Utilized company programs Safetyline, a window based program, and AS400 a dos based program.
  • In a previous position as a ALJ Audit Analyst. Took care of notices from the Medicare Adjudicated Law Judges to set up hearings and assist in any problems with the notice of hearing by contacting and working with legal assistants and lawyers. Maintain and creating spreadsheets on when the hearings were to be held, who was going to attending and what paper work was needed.
  • Before that as an Audit Analyst, took care of ordering medical records from Doctor's offices and Hospitals. Worked on gathering paper work for Infusion and enteral Audits.
  • Utilized Microsoft Excel, Word, Outlook and PowerPoint. As well as AS400.

Education

High School Diploma -

Ozark High School
Ozark, AR

No Degree - Business Math

St. Petersburg College
Clearwater, FL

Skills

  • Accuracy and Precision
  • Healthcare regulations
  • Policy Interpretation
  • Verbal and written communication
  • Various Insurance regulations

Timeline

Benefits Verification Specialist

Organogenesis
03.2020 - Current

Audit Analyst

Lincare
01.2012 - 10.2019

High School Diploma -

Ozark High School

No Degree - Business Math

St. Petersburg College

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Valerie De Wijk