Bryan Nelson Email & Phone Number

Pittsburgh, Pennsylvania, United States

Greater Pittsburgh Area

• • Review and update Part A Debt Recovery Operations work procedures when necessary• Development of new Debt Recovery Workflow Management System using Agile and “Waterfall” development methodology• Product “delegate” – backup to product owner (Ops Support Manager)• Assist in writing “User Stories” and criteria needed to develop system• Work with developers and architects to write business requirements• Writing User Acceptance test cases• Handled Part A payments for COVID Advance/Accelerated Payments program in March and April of 2020 for 15 US States and Territories by reviewing payments listings for duplicates and accuracy prior to submitting for processing.• Developed enhancements to existing internal workflow systems• Submit and work with HIGLAS maintainers on enhancement requests to Medicare payment system for various reasons.• Data analysis, identifying trends and potential cost saving opportunities.• Assist DR Operations with complicated tasks whenever necessary.• Research Medicare Financial Management Manual, Change Requests and Technical Direction Letters and implement changes to procedures and processes.• Coordinate with other internal departments as well as CMS on key process changes as well as customer inquiries.• Support Debt Recovery Parts A and B in both Novitas Solutions and First Coast Service Options.• Subject Matter Expert in all workloads for Part A lines of business.

Pittsburgh, Pa

Part A Debt Recovery• Develop, review and update of department procedures and work instructions based on system changes, CMS change requests, staff feedback and Root Cause Analyses.• Ongoing training of staff and new hires and maintaining training documentation.• Gathering of documentation for Audits, primary Part A point of contact for Auditor questions.• Frequently travelled to Jacksonville, FL office to facilitate ongoing staff training during transition from Pittsburgh to Jacksonville office locations.• Data analysis, identifying trends and potential cost saving opportunities.• Quarterly reporting of overpayment collection data to CMS of Office of Inspector General (OIG) and other contractor-initiated overpayments. • Attended LEAN Kaizen Bankruptcy Notification improvement conference at CMS Philadelphia Regional Office in July 2018. Continue to attend weekly meetings regarding messaging about importance of timely bankruptcy notifications.• Assist Part A and Part B Technical Assistants and Supervisors with complicated tasks whenever necessary.• Research Medicare Financial Management Manual, Change Requests and Technical Direction Letters.• Coordinate with Claims, Appeals, Audit and Reimbursement, and UPIC support departments on key process changes as well as customer inquiries.

Pittsburgh, Pa

Part A- Debt Recovery• Direct Assistant to Supervisor• Oversee Debt Recovery Financial Correspondents• Ongoing training for staff and new hires.• Assist Customer Service provider inquiries• Communicate with CMS regarding provider bankruptcies.• Quality Check staff work• Assist in compiling report data sent monthly to CMS• Assist staff members with complicated duties whenever necessary.• Work with Business Analysts and Business Coordinators on special projects and Change Requests from CMS.• Update and revise business procedures when necessary. Plan and implement new procedures based on new guidelines and audit observations/findings.• Work directly with CMS on aged bankruptcy debts.• Work with Benefit Accounting Department processing Extended Repayment Plans• Assist Benefit Accounting to resolve accounting variances.• Coordinate with Appeals Department on Appeals processing• Assist Audit and Reimbursement department with answering provider inquiries.• Provide technical assistance for Part B staff ALJ calculation inquiries when necessary.

Pittsburgh, Pa

Accounts Receivable Part A• Cost Report Settlement processing• 935 claims processing adjustments, specializing in complicated Partial adjustment decisions and refunds.• Manage 935 MAS reports and disbursement of work to 935 staff• Managed Hospital Appeals Settlement Project (HASP) HIGLAS reconciliation.• Research and update claim collection information in HIGLAS for Hospital Appeal Settlement project before payment spreadsheets are sent to providers for approval.• Oversee Cost Report Holds during busy periods.• Daily cost report hold verification.• Backup for applying receipts in HIGLAS• Backup for As Filed Cost Report Payments workload.• Oversaw underpayment backlog cleanup in summer 2014.

I manage day to day operations while at the same time providing customer services. I am heavily involved with strategic planning with the owners of the company. I set the specials, run the social media marketing, adjust the layout of the sales floor and beverage cooler to maximize sales of higher margin products. I reconcile the bank accounts, order inventory, maintain accounts receivable for wholesale soda deliveries. I networked the security cameras so I can keep an eye on the store from remote locations. I am the primary contact person for our wholesalers.I am truly the "do-it-all" person here.

Cash ManagementEmployee SchedulingInventory ManagementMarketing/Social NetworkingProduct Placement