Donna Griffith Email & Phone Number

Glens Falls Ny

Saratoga Springs, New York, United States

Upfront billing and follow up of medical insurances, to include no fault and workers compensation. Review claims payment for accuracy and resubmit corrected claims if necessary. Work with patients to understand their financial responsibility.

Albany, New York Area

Business Analyst with over 20 years of experience resolving organizational problems by assessing business performance and suggesting corrective actions. Evaluate project progress, identify problems, develop and implement company procedures. Excellent skillsets in leadership, analytical thinking, attention to details, problem solving and communication. Responsible for all Marketing mailings to include regulatory as well as ad hoc.

Albany, New York Area

Reviewed all group and member level transactions for accuracy. Review consisted of group set-up, correct benefits applied, members enrollment and ID card creation to be accurate. Daily reviewed all CDH and shared health groups for correct set-up and reimbursement. Met with and coached staff monthly to discuss their production and QC score, and determine course of action to correct weak areas that required improvement.

Berlin, Vt

Audited all claims types: physician, facility, and pharmacy to ensure proper payment had occurred. Reviewed all membership processed to include group and member level transactions and ID card creation to validate enrollment is accurate and timely. Audited calls to Customer Service for accuracy as well as protocol in answering inquiries. Created reports for Executive Staff to display the Plan's accuracy and timeliness, which would allow the plan to maintain the logo. Twice annually I would survey the Plan's largest group and tabulate the scores to determine if a penalty due the group should be paid.

Berlin, Vermont

Processed medicomp, physician, facility and pharmacy claims. Worked and reviewed suspense reports twice weekly which would push claims through the adjudication process. Processed bills to reimburse providers for Medicare as prime payment.