Beth Michuda Email & Phone Number

Remote

Demonstrated leadership by taking over the management of both the Benefit Verification and Prior Authorization teams during a period of transition, successfully implementing strategic initiatives and achieving boosted team morale and increased efficiency. • Spearheaded a team to successfully implement and adapt to changing workflows in team queues, ensuring streamlined productivity during periods of outsourcing and layoffs. • Regularly reported production metrics and communicated evolving workflows to the Director of Revenue Cycle, providing crucial insights for informed decision-making and strategic planning.• Successfully led the transition of front-end employees to back-end claim resolution, ensuring the accurate adjudication of $540,000 in claims within a two-month timeframe. • Effectively navigated and facilitated team changes, maintaining seamless communication and workflow continuity during transitions.

Supervised a team of 16 employees, overseeing responsibilities such as managing time cards, processing time-off and expense requests, and tracking key performance indicators (KPIs). Conducted quarterly and yearly performance reviews for each team member and served as a mentor to foster professional development. Provided targeted coaching to underperforming team members, achieving a notable 24% improvement for the lowest.• Enhanced team productivity by 11% and achieved region-specific right-size metrics through a comprehensive time study. Spearheaded the creation and implementation of a new metric system based on the study findings.• Implemented a streamlined process facilitating handoff between benefit verification and prior authorization teams, resulting in a significant annual time savings of 640 man-hours.• Detected system inaccuracies in the submission logic project and delivered constructive feedback to the project team resulting in a workaround solution, ensuring smooth and accurate processing.• Played a key role in the Recoupment Project within the Accounts Receivable department, successfully appealing recouped payments.

Designed and implemented a comprehensive training program, conducting remote training sessions for additional team members. Functioned as the primary point of contact for team escalations and inquiries, demonstrating effective communication and support.• Streamlined and upheld Standard Operating Procedures (SOPs), leading to the team achieving the highest initial Quality Assurance (QA) baseline.• Optimized training documents, resulting in new hires consistently achieving high QA scores immediately after release.• Devised and provided knowledge assessments throughout training, ensuring a comprehensive understanding of materials among team members.• Created and implemented a standardized notation system for benefit verification work, promoting uniform understanding across all RCS teams.

Established and maintained Standard Operating Procedures (SOPs. Created comprehensive training documents for the team, serving as a valuable resource for ongoing education and reference. • Conducted in-person and remote training sessions for new hires, providing expertise in Salesforce and Zio systems, benefit verification processes, estimated out-of-pocket costs for patients, and effective calling procedures and etiquette. • Continued duties from the Benefit Verification Specialist II role, maintaining a commitment to excellence in training and fostering team success. • Collaborated with Manager and QA Manager to enhance score card for quality assurance checks.• Conducted quality checks and provided constructive feedback during and after training sessions, ensuring consistently high-quality results post-training.

Lincolnshire, Il

Successfully obtained medical insurance benefits through a combination of utilizing online portals and engaging in effective communication with insurance companies for the Advanced Benefit Check program.• Conducted outbound calls to physician offices, hospitals, and patients, effectively obtaining corrected insurance information and ensuring accurate data.• Contributed to various projects, including those related to special insurances, claim submission errors, and assessing process flows for potential automation of estimated out-of-pocket calculations including obstacles and proposed viable.• Conducted in-depth research on claims processing, validating that benefits aligned with claims processing protocols, including authorization requirements, medical document requirements, and network status easing team workflow.

Libertyville

Oversaw front desk operations for both MRI and Physical Therapy departments, taking charge of insurance eligibility verification, benefits assessment, authorization acquisition, and the appeals process for denials.• Managed the end-to-end process for MRI and Physical Therapy appointments, including scheduling, patient screening for MRI exams, check-in procedures, obtaining authorizations, and processing payments for services.• Conducted outbound calls to insurance companies to obtain physical therapy benefits and collaborated with worker compensation adjusters for approval of services.• Calculated estimated out-of-pocket expenses for patients undergoing physical therapy, contributing to transparent and informed patient financial interactions.

Highland Park, Il

Aided nurses in direct care of patients in hospital setting on stroke, oncology, and general medical floor. Performed bathing, toileting, ROM, vital signs, telemetry monitoring, feeding, bladder scans, and other duties dictated by nurse for care.