Andrew Vasbinder Email & Phone Number

Jacksonville, Nc

• Determines, on a weekly basis, the five highest claim denial reasons based on the dollar amount of denied claims for Medicaid and State insurances then audits a sample of each denial reason to determine if the denials are valid or if a system issue is causing invalid claim denials.• Assembles weekly graphs, based on the five highest claim denial reasons, to track the denials across four consecutive weeks and analyze if there are any spikes in denials that need to be researched and corrected.• Researches any spikes in the denial graphs and reports findings that include steps that have been taken to correct any issues to necessary supervisors.• Produces a monthly claims dashboard for management that displays key claims processing statistics, audit findings, top providers payments, top ten claim denial code analyses, interest payments, and eligibility and enrollment data.• Performs monthly audits on Medicaid claims to guarantee the reports being used are correctly pulling claim information and also that claims are processing correctly to prepare for State mandated audits.• Analyzes monthly denial data and generate a report that details the top three claim denial reasons and the three providers that billed the most claims denied for each particular reason.• Took on additional short term tasks and responsibilities to help ensure a smooth transition during our company’s consolidation.• Maintained all assigned tasks throughout our consolidation and have continued to keep all tasks up to date even with the size of our company and our received claim volume nearly doubling.• Regularly team up with Claims Specialists to address any provider billing issues and/or system issues that are causing unnecessary claim denials. • Created reports for each audit completed that detailed the scope of the audit and any issues identified and the steps taken to address each issue.

Ahoskie, Nc

• Assembled a 3% random sample of received claims weekly and then audited each claim against a variety of data points to ensure our claims processing software was correctly processing claims of all statuses.• Completed weekly audits on Inpatient Hospitalization claims and notified supervisor of any errors or discrepancies with how the claims were processing.• Used reports to determine consumers that recently had Medicaid insurance added into our system, then would gather previously received claims that, as a result of the added insurance, would now approve to pay after being corrected by the Claims Specialists.• Created reports for each audit completed that detailed the scope of the audit and any issues identified and the steps taken to address each issue.

Commodore, Pa

• Worked collaboratively with 5 other staff members to keep children attentive and participating in daily activities, adjusted individual programs to make them more effective. • Participated in activities with the children that included sports, education, and various other topics. • Also reported daily to the program leader to improve the overall program.

Bsba, Marketing, 3.629

Activities and Societies: Clarion University Honors Program, American Marketing Association

Education record