• Investigates claim issues providing resolution within departmental and regulatory guidelines.• Interprets and administers contract provisions: eligibility and duration• Accurately codes all system fields with correct financial, diagnosis and duration information.• Coordinates with other departments to ensure appropriate claims transition or facilitate timely return to work.• Document claim updates in the claim database ensuring accuracy.• Maintaining departmental and policyholder expectations.• Adheres to compliance, departmental procedures, and Unfair Claims Practice regulations.• Actively contributes to customer service, quality and performance objectives.• Proactively engages in departmental training to remain current with all claim management practices.• Responsible for managing Performance Guarantee clients and meet targeted metrics.• Responsible and accountable for maintaining and protecting personal health information. Must maintain a high level of confidentiality and abide by HIPPA rules and regulations.

• Retrieve medical documentation needed in order to get reimbursed • Establish excellent communication with Doctor’s and personnel • To bring the total held billing down from the state of Nevada down each month 10%• Execute and complete personal projects given • Attends courses to improve knowledge of new policies being implemented • Delivered positive results to retrieve reimbursement for the department total held revenue.• Organize weekly excel worksheet to reflect clients with outstanding balances

Assesses the needs of over 75 patients a month for the best choice of equipment and or services to meet those needs. • Instructs patients/clients in the proper use and care and of equipment according to the written policies and procedures for that equipment. • Completes patient/client accounts paperwork. • Uses sound decisions in the best interest of the patient and company in regards to equipment choice. • Participates and attends educational meetings and seminars from manufacturer reps on equipment.

Patient care • Set up and delivered DME (durable medical equipment) for patients

Supervised a team of 10 Patient Care Technicians to ensure projects stayed on track and were delivered under budget. • Managed and maintained team, process and procedures to ensure positive results for the patient and company. • Analyzed data and provided recommendations which resulted in adoption of new cost-saving equipment. • Engaged with physicians in the field to help instruct on new equipment and set up equipment in physicians' offices for new patients. • Expanded sales and market for DME by developing new sales and marketing plans to include hospitals and physician offices. • Delivered positive results to grow revenue year after year.