Erna Van Acker Email & Phone Number

Madison, Wi, Us

Madison

•Use management skills to effectively manage area of responsibility.•Provide direction through one-on-one interaction with grievance/appeal staff, audits of cases and development of policies and guidelines. •Establish strong working relationships with all other WPS working units, to foster understanding and acceptance of WPS grievance/appeals regulatory requirements and policy applications.•Responsible for the facilitation of the grievance/appeal committee ensuring motions are applicable and accurate.•Use expertise of the grievance/appeal processes to evaluate and resolve grievances prior to acknowledgement.•Assures critical timelines are met.•Apply and maintain professional knowledge to resolve and manage issues in daily operations and management of staff.•Keep abreast of State and Federal insurance regulations.•Independently analyze case information to arrive at appropriate decisions regarding action taken on very complex cases.•Analyze and take action on root cause issues.

Madison, Wi

Responsible for the timely and accurate response to the customer, provider and/or Office of the Commissioner of Insurance written grievance/appeal requests and responses. Chair the Grievance/Appeal Committee ensuring contract benefits are correctly administered. Present analysis of “root cause” findings to the appropriate areas, confirming that follow-up is completed and needed changes are implemented.Provide leadership, technical expertise, and guidance to the grievance.appeal staff, as well as other operational areas, with respect to the application of benefits and contract interpretation.Conduct Corporate Grievance/Appeal committee meetings and communicate tthe Corporate meeting decision to the customer and/or the provider. Demonstrated ability to quickly and accurately assess and resolve grievances.Responsible for ensuring root cause issues are identified and to take action on the identified root cause confirming departmental follow-through for resolution.Work with affected management staff to develop, document and implement new workflows.Review the work and performance of the Specialists and Analyst assigned to the unit and provide appropriate feedback and prepare performance appraisals.Conduct regular needs assessments to determine whether current staffing needs are being met.Resolve problems, issues, concerns and conflics between subordinates, peers and Departments.Coordinate the work efforts of various staff within and outside the division to meet deadlines.Monitor department compliance with OCI requirements.

Associate Of Arts (Aa), Marketing

Education record