Jeff Wynn Email and Phone Number

•Preform Medical and Dental Claim Data Analysis using GeoAccess, DisruptionAnalysis, as well as internal Disruption tools and Marketing software.•Prepare and present Claim Data Analysis reports to Clients or prospective Clients (RFP) showing total claim dollar savings and/or provider penetration.•Make PPO Network recommendations to Clients and Prospects (TPA, Employer Groups, Insurance companies) based on network savings, penetration and geographical area.•Manage projects related to EDI workflows, EDI implementations, Eligibility file exchanges, system changes, and PPO Network contracting (BAA, NDA).•Manage PEPM and percent of savings payments between clients and 40+ PPO Networks.•Work with OCR vendors, clearinghouse vendors, PPO Networks, and ancillary networks related to claim issues, workflow issues and system upgrades. •Past Project Management for: 5010 conversions, ICD10 conversions, vendor and PPO Network implementations.

•Map provider data files to ppoONE database.•Manage ongoing load process for multiple PPO Networks and audit for accuracy.•Create and maintain fee schedule data in order to increase the number of automated claims repricing. •Perform quality analysis of database after upgrades are performed.•Research, identify, and resolve daily claim repricing issues in an efficient, accurate, and timely manner.

Provided technical and functional support to PPO Networks by tracking all issues and questions received from clients and ensuring same day responses were prepared and communicated to customers.