PROFESSIONAL SUMMARY
Creative, pragmatic, and proactive problem-solver. Organized and attentive to detail. Demonstrated time management skills. Strong research, mediation, and analysis skills. Proficient in evaluating needs and coordinating resources to efficiently complete tasks.
Key Skills include:
• LEAN
• Data Analysis
• Process Improvement • HIPPA Compliance
• Revenue cycle
• Needs Assessment • Medical EHR systems
• Training and auditing
• Quality Improvement
EDUCATION
Master of Business Administration, Healthcare Management 2019
Western Governors University | Salt Lake City, UT
Relevant Coursework: Service Line Development, Data Driven Decision Making, Social Responsibility
Bachelor of Science, Biology - Allegheny College | Meadville, PA 2016
PROFESSIONAL EXPERIENCE
Care Coordination Operations Specialist, Sutter Health, Sacramento, CA 08/2017 – present
Insurance Appeal – Denial management through account research for appeal processing within a specified turnaround time and compliance of Medicare and commercial payers. Interpretation of contractual and financial payer risk information for account processing quality. Data trending and analysis for the identification of issues with commercial payers resulting in 3 levels of internal escalations.
Creation of guidelines, job aides and process updates for team consistency, leading to a productivity increase of 21%, and a 39% decrease in returned accounts from payers.
Individual performance management for 5 peers to improve individual strategy, processes and quality.
Care Coordination Representative, Sutter Health, Sacramento, CA 08/2016 – 08/2017
Temp-to-hire from 08/2016 – 12/2018
Determined accuracy of utilization reviews based on interpretation of complex medical guidelines. Transmitted audited utilization reviews to external pay...
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