Kelcey J. Email & Phone Number

Salt Lake City, Utah, Us

Detroit, Mi, Us

- Led a CEO driven initiative by executing 19 projects focused on patient experience and workflow enhancements, delivering impactful results in frontend and back-end processes- Acted as an internal consultant for all revenue cycle functions and pitched project ideas based on performance gaps within a 6 hospital and 200 ambulatory clinic health system- Directed the successful implementation of an integrated billing platform, leading to a $10 million increase in patient payments within 3 months- Guided entry and mid-level project managers in performance improvement strategies, contributing to their professional development and project success- Led the coordination of cross-functional teams within hospital departments to ensure project alignment and successful outcomes for patient financial services, the Central Business Office call center, and various other programs that led to improved revenue for the health system- Managed and cultivated productive relationships with vendors to support project success and organizational goals- Demonstrated autonomy in overseeing complex projects involving coordination of multiple teams, driving system and operational improvements within HFHS- Led comprehensive reviews of hospital areas on projects, serving as a project lead for individual and multi-analyst initiatives

Detroit, Mi, Us

- Recruited to build the Authorization Department from the ground up based on a phased approach focusing on highest dollar impact - Achieved a 23% increase in authorization approval rate for ancillary services, leading to a $7m enhanced revenue generation within the first 6 months- Facilitated alignment of internal customers' business goals with senior leadership and stakeholders to achieve strategic outcomes- Guided and engaged in complex projects, collaborating with multi-disciplinary process improvement teams to drive system-wide enhancements- Investigated and resolved root causes for authorization-related claim rejections, improving revenue recovery processes- Managed a diverse staff of up to 80 employees, covering talent acquisition, compensation review, and performance management- Established metrics for process evaluation, facilitating continuous improvement initiatives- Collaborated with payers and third-party vendors to optimize authorization procurement and streamline appeal processes- Championed sustainability through the implementation of green initiatives such as cloud faxing and technology-driven workflows

- Analyze claims facts, data, Michigan No-Fault Law and policy documents to determine coverage or denials of claim benefits- Review various health insurance policies, auto policy and boat policy language to determine coordination of benefits, pro-rata or subrogation between carriers, including ERISA and COBRA regulations and guidelines- Handle pre-litigation resolutions by filing extensions and determining settlements with legal counsel- Utilize appropriate investigative tools (i.e. databases, information resources and public records) to verify information and/or identify investigative leads- Review medical records and conduct research to better understand correlation between mechanism of injury and medical treatment sought- Vendor management: case managers, private investigators and plaintiff attorneys- Project management: working with the MCCA for large loss claim resolution

Mayfield Village, Oh, Us

- Spearheaded the development and execution of a strategic fraud mitigation plan using lean principles to identify trends, conduct risk assessments, and implement internal controls.- Trained and mentored new employees on claims handling and Michigan No-Fault Law, fostering a knowledgeable and efficient team.- Analyzed policy language to determine coverage and benefits, ensuring compliance and accuracy in claims processing.- Collaborated with management on weekly inventory reports and claims assessments, providing insights to drive operational improvements.- Gathered and synthesized feedback from focus groups to propose alternative solutions, enhancing product and process effectiveness.- Managed projects focused on customer engagement and process improvements by recommending technological advancements.

- Secured authorizations from health insurance providers for diagnostic testing while ensuring compliance with CMS guidelines through thorough audits of patient files.- Addressed physician inquiries regarding diagnostic testing, enhancing communication and support for clinical operations.- Negotiated with MRI vendors to achieve a $4,000 weekly cost reduction by optimizing scheduling efficiency and decreasing machine utilization, leading to improved operational performance.- Managed payroll and employee time, streamlining workforce efficiency and reducing facility expenditures through strategic evaluation of operational costs.

Master’S Degree, Public Administration

Bachelor Of Science (Bs), Health/Health Care Administration/Management