Haley Eklund, Mba Email & Phone Number

Remote

Conduct analysis of inventory and performance metrics against targets, identifying root causes of any unexpected results. Collaborate with key stakeholders and business partners to present findings and establish appropriate action plans. Communicate daily, weekly, and monthly work plans to Operations team members and leadership, ensuring alignment of resources. Manage skills database and prioritize work assignments to optimize efficiency. Monitor data in real-time to identify issues and trends, promptly communicating any concerns to support Operations in meeting service levels and business goals. Work with Short Range Planners and Operations leaders to adjust staffing plans as needed based on evolving business requirements.

United States

Oversees day-to-day operations and production activities for a team of 35 medical coders. Establishes procedures to enhance departmental accuracy and effectiveness by promptly addressing routine and complex production challenges. Evaluates and manages daily workload and queues, analyzing coder productivity and comparing it to capacity plans. Identifies discrepancies and implements proactive solutions to minimize risks. Leads quality monitoring efforts to identify areas for improvement and develop implementation plans. Serves as the department's primary contact for addressing client issues and resolving problems. Develops competencies for coders, identifies training opportunities, and incorporates feedback from operational, financial, and quality assurance reports to enhance performance.

Responsibilities include investigating, recovering, and resolving all claim types for new day and adjustment requests. Knowledge of claim processing systems and guidelines. Solve range of problems to meet expectations of providers and members. Investigate commercial plan and state regulation policies and reimbursements. Audits claims processing and claim research to ensure proper payment is made to the provider and claim reflects accurate patient liability/cost share. Adjustments made on claims where UHC paid claims incorrectly. Knowledge working medical and hospital claims with any billed amount. Identity trends and suggest resolutions for claim issues. Additional responsibilities include reviewing daily claim inventory and team members matrix. Auditing team members work and providing education when necessary.

Responsibilities involve investigating, recovering, and resolving various claim types for both new day and adjustment requests. This requires a thorough understanding of claim processing systems and guidelines to effectively address provider and member needs. Additionally, this role involves investigating commercial plan and state regulation policies and reimbursements, as well as auditing claims processing to ensure accurate payments are made to providers and that patient liability/cost share is correctly reflected. Adjustments are made on claims in cases where incorrect payments have been issued by UHC. This position also requires expertise in working with medical and hospital claims of any amount, identifying trends, and proposing solutions for claim-related issues. Other duties include reviewing daily claim inventory and monitoring team members' work, providing necessary education and support as needed.

Vancouver, Washington

Committed to training staff on office procedures, ordering supplies, and obtaining authorizations. Generating reports to assess work queues. Implementing LEAN principles to reduce waste in the workplace. Collaborating closely with team members to enhance phone triage, release of medical records, response to record requests, insurance authorizations, procedure scheduling, supply procurement, and patient flow. Possessing strong organizational, administrative, and clinical office skills. Demonstrating exceptional interpersonal skills, a dedication to patient care, customer service, and the ability to work effectively with patients, physicians, and insurance providers. Verifying insurance coverage, obtaining medical authorizations, and managing referrals. Proficient in working both independently and as part of a team.

Vancouver, Wa

Responsible for performing duties on the Medical/Surgical floor, which includes accurately inputting patient information into the electronic medical record (EMR) system. This involves updating patient demographics and documenting clinical care provided. Key tasks include answering multiple phone lines, communicating with healthcare providers via VOCERA, and providing patients with important financial and regulatory information.Additionally, this role involves verifying medical orders through Computerized Provider Order Entry (CPOE), coordinating with other departments to ensure smooth patient transfers and discharges. Experience with EPIC in the Emergency Department is required, including efficiently registering patients upon arrival and updating demographic, insurance, and guarantor information.It is essential to stay informed about advancements in the healthcare industry, including participating in continuing education opportunities and engaging in process improvement initiatives.

Master Of Business Administration (Mba), Business Administration And Management, General

Bachelor’S Degree, Health/Health Care Administration/Management

High School, General