Kim Mitchell Email & Phone Number

Spokane, Washington Area

Working as a Business System Analyst for the last 5 weeks with duties including building and support business and technical components of the TPA infrastructure. Responsible for providing project leadership in implementing new business or technical processes. Recently promoted to Claims Supervisor responsible for the Recovery team.

Manage the daily operations of the Group Health provider payment and demographic systems, including the development and maintenance of state-wide financial and data systems. This also includes maintaining Group Health’s strategic goals, Standards and controls. Balance the competing needs of multiple and diverse departments to ensure that provider payments and related data are accurate, timely and coordinated with other corporate policies, systems and processes. Provide analysis and consultation to contract managers, associate directors and other Group Health administrators. Research and implement regulatory requirements, including systems development and reporting. Currently responsible for multiple specialty units that include Coordination of Benefits, Code Review, Kaiser, Other Party Liability, and the Pre-existing Condition Unit.Group Health – Pre Service Manager 2004 -2007Was responsible for a fast changing, high productive Pre Service department. Managed a team that on- lined authorizations for members according to their benefits. Applied medical management rules, worked with medical directors and clinical review nurses for clinical outcomes.Group Health – Pre Service Supervisor, Claims processor, DME, and Home Health 1993-2004Processed specialty claims, pre service authorizations along with coordination of durable medical equipment and home health per Group Health guidelines.

Administration

Education record

Business/Corporate Communications

Health/Health Care Administration/Management