Dana Pelky Email & Phone Number

Madison, Wisconsin, United States

Supporting the Wisconsin Department of Health Services

Racine, Wisconsin, United States

Performed various audit functions under subcontract for Medicare Administrative Contractors (MAC).Completed FY2023 Wage Index reviews for a MACCompleted reopenings related to Change Request #11642 – Updates to Nursing and Allied Health Education Medicare Advantage Payment PoliciesCompleted other Medicare cost report reopenings and audits and as assigned

Waukegan, Il

Provide superior hospitality to artists performing in the beautiful historic Genesee Theatre, as well as their crew, according to their specific needs and desires. Advanced meal and dressing room requirements with tour managers.Ordered catered meals, as needed.Scheduled hospitality staff for the day of show.Shopped for dressing room and meal and drink requirements. Set up food and beverages for artists and crew in multiple locations and restocked, as needed.Bused tables, washed dishes, and cleaned equipment.Iced down, re-iced, and dumped ice from containers.Reset beverage station for next use, as needed. Assisted obtaining some items or food requested by the artists or crew members.Called local businesses to ask for information or place orders.Assisted with additional errands or transportation.

Rapid City, Sd (Remote)

Prepared Medicare cost reports for various types of healthcare facilities. Performed other duties to assist healthcare facilities with their other accounting functions. Performed Accounts Payable functions for a nursing home.Payroll preparation for a nursing homePerformed month-end duties and prepared monthly financial statements for a nursing homePrepared and filed critical access hospital Medicare cost reportsAssisted in coding of trial balance to Medicare cost report lines for expenses and revenues for a new critical access hospital clientUpdated dashboards used by clients wiht lates filed Medicare cost report information

Kenosha, Wisconsin, United States

Safely sorted and scaned packages to be delivered to customers.Ensured correct sorting of packages based on delivery address. Responsible for correct stacking of pallets to protect packages from damage. Wrapped pallets for safety and shipping.

Bloomingdale, Illinois

Performed specialized Medicare reimbursement work including bad debt reviews and compilations.Worked independently on Medicare bad debt reviews and compilations for hospitals.Ran reports and queries in SQL Server to gather data for reviews and compilations. Performed account-level lookups on large samples of accounts to verify review findings.Used data and policies from hospital patient accounting and finance to analyze data and recover net revenue. Communicate regularly with F2 teams on status of engagements.

Milwaukee, Wisconsin

Prepared Medicare and Medicaid cost reports for Skilled Nursing Facilities using data supplied by the facilities. Compiled and sorted facility information into usable date to copy to Excel for calculation of data for cost report entry. Compiled information from facility invoices into usable data.Calculated total biweekly payments for inclusion in interim payments. Used compiled and calculated amounts to create electronic cost report files. Communicated with Skilled Nursing Facility clients to ensure accuracy of cost reports.

Calculated Medicare Tentative Settlements and performed Desk Level Audits of annual Medicare cost reports to determine final settlements for various healthcare providers including Acute Care, Critical Access, Psychiatric and Rehabilitation Hospitals, Skilled Nursing Facilities, Federally Qualified Health Centers, and End Stage Renal Dialysis Facilities. Adjusted Medicare payment rates for Skilled Nursing Facilities. Also served as in-charge auditor for the field audit of a large acute care hospital. Performed audits of data file on the costs report for the Electronic Health Records incentive payment for Acute Care Hopsitals. Determinied initial Electronic Health Records incenteive payment for actute care and critical access hospitals.Ensured accuracy and compliance with government regulations and company policies by performing second level reviews of calculations completed by other analysts. Assisted in developing and updating Excel spreadsheets used as templates for tentative settlements for Rural Health Centers and Federally Qualified Health Centers.Developed and updated an Excel spreadsheet used as a template for calculating the hospital specific payment for Sole Community and Medicare Dependent Hospitals.Created templates for biweekly payment schedules to be used in calculating tentative settlements, desk level audits, and interim rate reviews for skilled nursing facilities . Responsible for processing tentative settlement letters for the entire audit team to ensure proper entry into the tracking system and payment as mandated by the Centers for Medicare and Medicaid.Responsible for processing interim rate review letters for the entire audit team to ensure proper payment of the lump sum adjustment and correct changes to the payments for Skilled Nursing Facilities.Met strict deadlines imposed by The Centers for Medicare and Medicaid.Assisted new auditors with assigned tasks and answered questions.

Greater Milwaukee Area

Calculated Medicare Tentative Settlements and adjusted Medicare payment rates for various healthcare providers including Acute Care, Critical Access, Psychiatric and Rehabilitation Hospitals, Skilled Nursing Facilities, Federally Qualified Health Centers, End Stage Renal Dialysis Facilities and Home Health Agencies. Performed desk level audits of annual Medicare cost reports for Federally Qualified Health Centers to determine final settlements. Ensured accuracy and compliance with government regulations and company policies by performing second level reviews of calculations completed by other analysts. Assisted in developing and updating Excel spreadsheets used as templates for tentative settlements and interim rate reviews to ensure calculations incorporated changes in Medicare regulations, company policy, and department operating procedures. Served as key point of contact for team in implementing two new payment systems ensuring proper updates were made to the provider files and tentative settlement and interim rate review templates. Organized and analyzed large sets of Medicare claims paid to skilled nursing facilities..Assisted in implementing changes to Medicare’s payment systems as mandated by the Centers for Medicare and Medicaid to ensure accuracy of payments.Provided quality customer service to all types of Medicare healthcare providers by assisting them in deciphering payments for claims.Selected to manually calculate payments for claims that could not be paid using usual methods. Consistently met strict deadlines, both internal and those imposed by The Centers for Medicare and Medicaid, even as workload increased.Solely responsible for provider file updates for specific hospitals affected by the reclassifications mandated by Section 508 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.Trained new associates on all analyst job functions.Promoted from Analyst I to Analyst II in 2003.

Sheboygan, Wi

Inspected extruded plastic parts to ensure optimal quality was maintained during production.Inspected plastic parts extruded using new dies and relayed pertinent information to the engineering department regarding quality. Performed studies of past production measurements when customer’s specifications were consistently not within the tolerance values and relayed information to management or the engineering departmentAnalyzed production performance in relation to the quality specifications of the customer and reported findings to management.Independently learned quality software and taught supervisor how to use it to enhance quality analytics. Trained new inspectors.

Bachelor Of Science (B.S.), Mathematics

Minored in Economics.

Education record

Education record

Completed online courses for Microsoft Access, Microsoft Power Point, and SQL.