Dawna Kraft Email & Phone Number

Boston, Ma, Us

Taunton, Ma, Us

Canton, Ma

Coach and assist the Canton Reimbursement Specialists with their daily work load and completing benefit verifications.Interface with hospitals, wound care centers and sales staff to ensure the highest level of reimbursement is attained. Communicate and document pay trends. Monitor and update Medicare, Medicaid and Commercial policies and guidelines. Train all new hires. Perform case worker audits, call monitoring. Research of new product coverage/non coverage. Communication to the team on coverage changes. Perform audits of each team member to ensure quality and correctness of work. Perform benefit verification, prior authorizations and research medical policies and maintain a 24hour turn around time.

Canton, Ma

Investigate patient's medical benefits and identify opportunities for prior authorizations.Prepare and submit prior authorizations in a timely manner. Effectively interface with hospitals, wound care centers and physicians to insure the highest level of reimbursement is attained.Communicate and accurately document payor trends.Foster partnerships with national accounts.Monitor and update Medicare, Medicaid and Private Payor policies and guidelines.Monitor and communicate policy developments that impact the reimbursement success of products. Help build relationships in key markets with government, physician, hospital, and third-party payer decision makers.

Waltham, Ma

Assist sales and clinical team with all new orders and product requestsInside liaison between sales/clinical team and referral source and patientCoordinating the intake of patient information, verifying insurance benefits, and obtaining any required authorization and medical documentation.Assist sales and clinical teams with quarterly inventory.Monitoring and recording customer, physician and referral source communications. Notifying appropriate personnel at Surgi-Care if a particular service or response is required. Billing of all third party product as well as daily billing of stock and bill items Daily working of clearing house electronic rejections and claim status scrubbing reports Completion of all explanation of benefits and denials for multiple players including: Tufts Health Plan, Cigna Health, United Healthcare, Gentiva Carecentrix, Private Healthcare Statements, and Healthcare Value Management. Responsible for appealing denied claims, identifying incorrect payments based on contract provisions and the proactive identification of any payer issues.  Weekly and monthly working of all claim aging reports as well as independently managing personal AR and ensuring monthly and quarterly y goals are met and exceeded.Cross training in multiple departments as well as within own department. Also assisting with new hire training and peer education. Attending ADP customer service and leadership training sessions.

Watertown, Ma

Responsible for the verification of all client NPI, and Legacy provider numbers, as well as updating and follow up on new client reimbursement address changes. Generation of all EDI, ERA and EFT enrollment forms, as well as submission to the client and payer Follow up of all electronic enrollment forms submitted to payer, based on payer set timelines  Meeting and completion of all company set SLA and MSC goals.