Brandon Morey Email & Phone Number

Muskegon, MI, US

United States

Grand Rapids, MI

• Led a comprehensive preparation process for 2023 CMS Program Audit of PriorityHealth, achieving zero audit discrepancies and decreasing audit preparation efforts by66%, improving team productivity
• Executed comprehensive management of non-contract provider appeals, resulting in a30% increase in resolution efficiency and reducing the average appeal resolution timefrom 30 days to 15 days
• Analyzed and assessed root cause issues, facilitating a 50% improvement in resolutiontimes and enhancing operations efficiency across the team
• Manage and implement organization operation efficiencies for the entire network of82,000+ providers to resolve complex provider issues
• Developed and update audit spreadsheet for monthly team audits, resulting in a one-stopdata entry sheet for a team members monthly audits

Grand Rapids, MI

• Directed a 12-member team, integrating contract staff, to achieve appeal resolution timeof 60 days or less
• Engaged with cross-functional teams to collect and validate compliance data, ensuring100% compliance with CMS requirements
• Led a cross-functional team to prepare for ODAG and CDAG-related Mock CMSPrograms Audits, resulting in 95% compliance
• Achieved compliance with CMS rules and regulatory requirements by conducting weeklyaudits of team member workloads ensuring 100% adherence and avoiding potential finesof up to $250,000 annually
• Implemented process improvement project to move Appeals team out of excel data sheetsfor tracking into an automated system reducing data entry errors by 60% and increasingdata integrity by 80%
• Developed, maintained, and initiated new hire training decreasing on boarding time by50%

Grand Rapids, MI

• Executed comprehensive administration of Medicare managed care appeals for PriorityHealth, achieving an average resolution time of 45 days for post-claim appeals and 20days for pre-service
• Maintained appeal status via Excel sheet for compliance purposes with 100% data entryaccuracy
• Facilitated seamless customer and staff communication through detailed informationsharing and prompt follow-ups
• Promoted to Lead Coordinator after leading the team through CMS HPMS audit andachieving 95% accuracy

Holland, MI

• Delivered exceptional customer service by resolving 95% of issues on the first call,resulting in a 20% increase in customer satisfaction scores and a 15% rise in customerretention
• Fielded 30-40 daily calls from Medicare Members, satisfactorily resolving inquiries andcomplaints
• Advised on Medicare Benefits and claim statuses to 100+ members weekly
• Conducted 50+ personalized consultations per month, leading to a 60% conversion rate inselling Priority Health’s Medicare Advantage and Medigap plans, contributing to thecompany's revenue growth

Online

-Focused on schooling after moving from Ohio to Michigan

Newark, OH

-Coordinated new communications, issues and questions between internal and external customers-Set up new networks including, claim workflow and contract numbers for groups-Coordinated signing of network contracts with the Compliance Department-Requested, developed, and analyzed data using reports/tools

Newark, OH

-Took 60-100 calls per day-Advised providers and insured’s of claim status, issued EoB’s, and resolved complaints as requested.-Responded to emails and voicemails left by members and providers-Read and interpreted insurance plan language and advised of benefits as requested

New Albany, OH

-Negotiated payment arrangements for delinquent accounts-Solicited company benefits and payment options-Advised customers of ways to manage debt better-Handled multiple credit card accounts daily

Johnstown, OH

-Handled customer complaints while giving exceptional customer service-Handled money on a daily basis-Balanced cashier drawers-Cashed payroll checks, sold money orders, and processed utility payments-Administered customer satisfaction daily-Kept produce full, fresh, and packaged cut fruit

Master Of Science - Ms, Information Assurance/Cybersecurity

Bachelor Of Science (Bs), Health Care Administration, 3.02