Kelsey Long Email and Phone Number

Responsible for completing weekly analysis of work queues and identifying new issues that need to be resolved and bringing forward solutions for found issues or escalating issues when appropriate. Ensuring that the team is working in the most efficient and effective way. Participates in meeting with provider’s representatives and other departments within Mayo to resolve outstanding issues. Leads and participates in bi-monthly meetings with team to address current, ongoing and upcoming issues and changes.

Responsible for initiating and following up on precertification for all surgical procedures by providing CPT, ICD 10 codes and clinicals to insurance companies. Responsible for initiating authorization for hospital admissions with insurance companies. Assist patient with questions regarding precertification, and understanding their insurance coverage at Mayo Clinic. Working with co-workers, medical secretaries, insurance companies and patients to ensure excellent patient experience.

Responsible for processing work comp, liability and commercial insurance claims for durable medical equipment for all eleven Mayo Clinic Stores. This includes, verifying insurance, submitting prior authorizations, sending claims, fixing denials and sending appeals for both contractual obligation and patient responsibility denials. Answer phones, take payments over phones, explain insurance coverage to patients and take payments for their bills. Timely and accurately respond to all Medicare audits, appeal Medicare claims for all eleven of our stores. Assist in making training videos for both the business office as well as the store technicians.

Responsible for helping patients find the correct Durable Medical Equipment, as prescribed by physicians, as well as submitting the claim correctly to insurance and making sure patients understand how the Mayo Store works with insurance. Act as a go-between for patient and insurance company as well as interacting positively with patients to ensure quality service. As part of the inventory management team I helped manage 6400 products throughout the ten locations. I also maintained and updated our vendor and product information, as well as communicating issues with any vendors through the appropriate channels.

Working in the Mayo Clinic Store business office to help process insurance claims for durable medical equipment and pharmacy. Calling insurance companies on aged claims and reimbursing insurance companies for equipment that was returned as well as posting payments as they came in. While at the business office I also helped with Medicare audits and appeals. Manually posted an average of $300,000 of insurance payments a month.

Gained experience in:• Payroll using CGI• Recruiting, assisted in scoring resumes and forwarding to hiring managers using NeoGov• Personnel, assisted in re-writing and formatting employee handbook.• Benefits, worked on FMLA case.• Risk management, assisted completing a mock OSHA inspection.