David Carson Email & Phone Number

Philadelphia, Pa, Us

Product & Enablement Division (Previously known as Operations Growth Strategy)Goal: Drive payment integrity growth initiatives within existing COB product portfolio. Enhancing and expanding existing product portfolio performance while supporting implementation of new product initiatives for Coordination of Benefits (COB).Prospective & Retrospective Payment Integrity Product management, Product / Project lifecycle management, Workflow Optimization and analysis, experience with SAFe, PI planning, & Scaled Agile environments, Cross-functional leader.

Philadelphia, Pennsylvania, United States

Content & Enablement Division (Previously known as Operations Growth Strategy)Goal: Drive payment integrity growth initiatives within existing COB product portfolio. Enhancing and expanding existing product portfolio performance while supporting implementation of new product initiatives for Coordination of Benefits (COB).Prospective & Retrospective Product management, Product / Project lifecycle management, Workflow Optimization and analysis, experience with SAFe, PI planning, & Scaled Agile environments, Cross-functional team leader.

COB Payment Specialist/Analyst Accomplishments for 2018: Identified over 4 million dollars in gross ID for incorrectly paid claims to be recovered for our clients.• Employs healthcare coordination of benefits audit procedures to identify and outline outstanding problems and issues related to client data. Analyzing and developing criteria to audit reports ranging from standard-complex to identify and validate over or incorrectly paid claims. • Meets or exceeds standards/guidelines for productivity. Sustains production and strategic goals and quality standards set by the audit. • Provides statements to client disputes. Provides verification and evidence for the claims identified and audited, providing additional details in a concise and professional written manner. • Effectively utilizes audit tools. Operates with proficiency, using both Cotiviti and client tools required to perform duties. Initiates solutions to provided datasets to help generate new ideas for claim concepts and recovery opportunities.• Researches and provides recommendations for new opportunities/concepts and business processes. Initiates new approaches and technological enhancements that will support and improve audit production, SQL reports, communication, and client satisfaction.

Blue Bell, Pa

555 East North Lane, Conshohocken, Pa 19428

• Cooperate with Medicare and commercial health insurance providers to support recovery audits.• Provides General Administrative Support. Perform a variety of support and general administrative assignments in support of the audit or auditors, including filing, data entry, tracking and correspondence following established standards and work processes. • Provides Communication Support. Serves as a point of contact and facilitate responses to general inquiries and data requests from both internal and external customers. As requested or required, communicates directly with the client or providers following established processes and procedures.

Greater Philadelphia Area

• Provides research support in rat models focusing on cardiovascular recovery after spinal cord injury using neural stem cells.• Assists in examining behavioral aspects of spinal cord injury in the autonomic system using cystometry to analyze micturition and pharmacological effects of dopamine. • Manage rat colonies for breeding and spinal cord implants, providing project and time management for experiments

Greater Philadelphia Area

• Provide research support in mice model experiments focusing on endocannabinoids (CB2 receptors).• Assist in examining the behavioral aspects of pharmacology effects in mice models for endocannabinoids & stroke recovery on cognition.• Assist in conducting experimental conditions and data collection for protocols and procedures for drug & behavior testing.• Trained new students on procedures and techniques needed to be done

Master Of Business Administration (Mba), Specialization In Business Intelligence And Analytics

Master Of Business Administration (Mba), Specialization In Pharmaceutical And Healthcare Business

Bachelor Of Science (Bs), Neuroscience

Graduated Jan 31, 2014 Major: Neuroscience Minor: Psychology