Wendy Partenheimer
Vendor Coodinator
Allerton,Illinios
Summary
I have an employment history that made me adaptable to the changes and demands within my work environment. Past employers have given me exceptional recommendations. I can bring a multitude of outstanding attributes to any team. My professional, honest, and friendly personality has left patients, providers, and staff feeling comfortable and reassured. I have experience and knowledge of medical billing, coding, and contracting. I have the drive to effectively collaborate with any team. Twenty years of experience in the health care and insurance industry will make me an asset to any health care or insurance position.
Organized professional with proven track record in vendor management. Skilled in fostering strong vendor relationships and optimizing procurement processes to drive operational success. Recognized for team-oriented approach and adaptability to evolving business needs, ensuring reliable and flexible support.
Overview
21
21
years of professional experience
Work History
Vendor Coordinator
Health Alliance
01.2019 - Current
- Manage vendor utilization including workflows and coordinating services between the vendor and Health Plan.
- Analyzing vendor data, audit/monitor vendor reports and sharing the findings with our compliance team within the LogicGate reporting system.
- Create and manage vendor scorecard and associated ratings/correction plans.
- Perform as a key account manager for the Health Plan, managing high priority provider and member issues.
- Assist with the Medical Management Oversight Committee team regarding vendor expectations, performance, and procedures.
- Educate and communicate expectations on performance and procedures to various cross-functional departments.
- Research and resolve claim disputes with vendor, member, or provider. Route these issues to an appropriate person(s) for resolution if necessary.
- Ensure operation integrity, including compliance with all policies and procedures for the Health Plan including adherence to state contracts and guidelines.
- Creating and developing corrective action plans for the vendor.
- Analyze ROI of vendor.
- Track and report progress on vendor issues. Facilitate and document meetings with the vendor.
Supervisor
Sidell Township
01.2018 - Current
- Conduct monthly meetings. Prepare Annual Budget and Levies for Township. Manage and balance accounts and expenditures. Stay up to date on new state legislation that applies to the Township.
- Prepare an Annual Report and submit it to the state. Present Annual Report, budget, and levies to our trustees and community.
- Manage all budgetary allocation of assigned funds.
Medical Billing and Coding Contractor
PatheousHealth
01.2014 - Current
- Code and key all Medicare billing encounters with CPT and diagnostic codes into Advanced MD and NetSuite systems.
- Assist with providers contracting and credentialing.
Claims Lead
Health Alliance
01.2018 - 01.2019
- Claims Lead over the Self-Funded Team and Support Staff. Monitor turnaround time for claims and ensure they are accurate. Knowledge regarding contractual agreements between ASO clients and their health care providers; monitors charges and verify correct payment on claims and capitation deductions.
- Lead meetings and committees to deal with short-term or ongoing issues. Keep staff educated on current and past processes. Recommend and initiate various personnel actions such as hiring, performance appraisals, disciplinary action, and promotions; create work assignments, review and edit work of direct reports.
Medical Billing Specialist and Central Intake Supervisor
C-UPHD, Health Department
01.2013 - 01.2019
- Billed Medicare, and Commercial Insurance encounters, making corrections, and ensuring all CPT and ICD-10 codes were billed accurately. The company utilized Insight for its EMR. In the past I have used Med3000. Clearinghouse experiences are with Availity and MD On-line (MDOL).
- Entering all 835’s and manual payments into the system.
- Lead role in establishing our facilities Meaningful Use.
- Provider insurance contracting and Medicare revalidation were also part of my job.
- Supervisor over the Central Intake Division. The position was responsible for hiring, training, evaluations, and terminations of the Intakes. Other responsibilities were the entry of valid insurance, checking eligibility, and completing ACA and Medicaid applications.
Medical Office Assistant
Dr. William Price MD, Orthopedic Surgeon
01.2009 - 01.2011
- Responsible for clinical activities to ensure the provision of optimal clinical services. Performed technical patient care procedures and assisted the physician with wound care. Administered medications and interpreted various patient results to determine urgency of care. Insured that all medical records and documentation were accurate and signed. Proficient in the procedure of correct charting. Participate in the implementation of plans, policies, and procedures. Communicate and interpret policies to new or temporary personnel. Participated in staff orientation and in-services. Ordered all medical supplies.
- Evaluate clinical staffing needs. Manage patient care problems by acting as a clinical resource. Triage patients, answer questions from patients and family members. Oversee routine administrative matters necessary for clinical operation. I was responsible for all correspondence and authorization from insurance companies. Performed accurate medical coding. Responsible for community outreach and informing the community of our programs and services.
- Reason for leaving: Physician relocated practice out of area
Clinical Services Team Leader
Dr Robert Brown MD, OB/GYN
01.2005 - 01.2009
- Supervised the activities of clinical personnel to ensure the provision of optimal clinical services. Rooming patients, collecting vital signs, reviewing medications, updating medications, setting up sterile environments and accurately selecting correct instruments for procedures. I administered medications and interpreted various patient results to determine urgency of care. Ensure all medical records and documentation were accurate and signed.
- Triage patients as well as being responsible for coordinating and scheduling complex surgeries and procedures. I was responsible for all correspondence and authorization from insurance companies. Performed accurate medical coding for in office and surgical procedure, as well as a small amount of charge entry as needed for our office. Participated in community outreach and informing the community of our programs and services.
- Reason for leaving: Physician relocated Practice out of area
Education
Parkland College
Champaign, ILSkills
- Procurement expertise
- Logistics management
- Strategic negotiation
- Relationship management
- Budget management
- Vendor relationships
Timeline
Vendor Coordinator
Health Alliance
01.2019 - Current
Supervisor
Sidell Township
01.2018 - Current
Claims Lead
Health Alliance
01.2018 - 01.2019
Medical Billing and Coding Contractor
PatheousHealth
01.2014 - Current
Medical Billing Specialist and Central Intake Supervisor
C-UPHD, Health Department
01.2013 - 01.2019
Medical Office Assistant
Dr. William Price MD, Orthopedic Surgeon
01.2009 - 01.2011
Clinical Services Team Leader
Dr Robert Brown MD, OB/GYN
01.2005 - 01.2009
Parkland College
Similar Profiles
Melissa L. MurphyMelissa L. Murphy
PROVIDER RELATIONS SPECIALIST at Health AlliancePROVIDER RELATIONS SPECIALIST at Health Alliance
Khalid AlshubayniKhalid Alshubayni
Pharmacist at Health alliancePharmacist at Health alliance
Tara DixonTara Dixon
Member Relations Coordinator at Health AllianceMember Relations Coordinator at Health Alliance
Deborah RigbyDeborah Rigby
Community Engagement Officer- PREVENT at Liverpool City CouncilCommunity Engagement Officer- PREVENT at Liverpool City Council
Lori LunsfordLori Lunsford
Family Support Specialist at Mid Iowa Family Therapy Clinic, Inc.Family Support Specialist at Mid Iowa Family Therapy Clinic, Inc.