Aaron Thomas Email & Phone Number

New York, United States

New York, Ny, Us

• Contribute to high level conceptual thinking and conduct operational data analyses to develop actionable information in the form of recommendations, conclusions and possible solutions to root cause analyses. Produce reports to evaluate operational efficiencies and effectiveness.• Prepare dashboards and other management reports, soliciting information from staff throughout the company and serve as liaison to them for their submissions and quality control• Identify and collect internal historical data; research and collect external benchmark data; devise more efficient and accurate approaches to vet and prepare metric reports; use sound reasoning and judgment for identifying and applying appropriate analytical approach.• Recommend and implement accuracy, efficiency and productivity enhancements.• Plan, execute, and own multiple and simultaneous team-based projects along with other individually assigned projects, including providing support in developing and expanding the scope of the company’s corporate dashboards and other management reports for distribution to middle and upper management.• Organize and maintain report documentation.• Take initiative to continuously develop more efficient ways to produce reports• Communicate and collaborate with internal stakeholders to support overall quality and customer experience objectives.

Long Island City, Ny, Us

• Identify and rectify systemic reimbursement inadequacies and provide reports instrumental to quantifying the financial impact and reduce the issues from happening in the future. • Utilize SQL to obtain data for financial impact analysis, contract implementation QC, claims oversight, fee schedule validations, and various adhoc reports.• Collaborate with IT to maintain, test, and implement configuration through claims data for AWP, Medicare, and Medicaid claims with heavy emphasis on data integrity and data warehouse accuracy. Including routine quality control measures and data warehouse updates to ensure all claims are paid accurately.• Lead weekly meetings with various business partners to identify and assess all types of claim issues which affect both parties, with focus on delivering timely, accurate and permanent resolutions.• Provide analytics empowering Contracting to negotiate complex methods of reimbursement using end to end quality control measures to ensure accurate configuration and implementation.• Built, maintained and presented reports to aid the Sr Manager of Provider Reimbursement with outstanding dollars recouped via retractions.• Automated monthly and quarterly deliverables. Using Access to streamline a macro driven database that generates non-facility, facility, clinical lab, and DME fee schedules.• Lead a team of analysts on claims oversight, reviewing denials, pends and other inquires providers have regarding their claims.

Ny, New York, Us

• Generated and distributed adhoc reports for the Sales, Contracting, and Claims departments• Queried claims data for provision of a monthly report empowering Hospital Advocacy to complete various ARs • Managed and distributed a weekly report where I provided pricing for claims that were unpaid due to systemic issues• Co-labored with the Director of Actuarial Analytics and Provider Contract Process on a project that yielded an 80% reduction on the weekly report of claims unpaid due to systemic issues• Utilized Microsoft Access to create a database that generates Medicare fee schedules based upon the input of a zip code• Partnered with the Network Manager to create a process for simultaneously updating fee schedules tied to special agreements • Collaborated with IT and Network Contracting on creating, testing, implementing, and maintaining fee schedules• Paired up with the Senior Medical Director and the Director of Actuarial Analytics and Provider Contract Process to facilitate the implementation of annual AMA CPT code updates

Ny, New York, Us

• Maintained an average quality grade of 97% when processing claims• Responsible for processing and overseeing provider updates ensuring accuracy of our webpage, proper payment of claims, and increased efficiency of systemic claim processing• Monitored data imports that reflected billing and service location data sent to the system• Created and generated reports to give an overview of the age and total of claims yet to be processed• Distributed Workers Compensation claims to MagnaCare's Data Team to be priced and sent to the clients• Executed eligibility file loads and updated membership eligibility ensuring up to date information in regards to member coverage