Krista Powell Email and Phone Number

- Review and discuss insurance company’s explanation of benefits to patients and providers.- Process payments over the phone from patients and negotiate payment arrangements.- Ensure accurate claim filing and refiling by entering accurate insurance information, confirming HCPCS codes and diagnosis codes and confirming receipt of supporting clinical documentation.- Respond to patient general inquiries, information updates and billing questions while resolving problems with accuracy and professionalism.

• Orchestrated multi-departmental operations, achieving a significant 90% reduction in error rates and an 85% decrease in staff turnover through effective management and team development strategies.• Ensured strict adherence to performance and quality standards, alongside managing document control processes, while working with various departments to capture and document requirements which resulted in 90% document accuracy and compliance.• Completed root cause analysis for business data issues.• Facilitated clear communication of productivity metrics and call center activities to senior management while also providing essential data for board reports and audits.• Developed and implemented quality assurance systems and operational processes, focusing on process refinement, training needs identification, and staff productivity, ensuring alignment with organizational goals and values.• Helped track progress and impact of performance, created Key Performance Indicator reports, and provided solutions for improvement.• Built reporting solutions and educated end users on how to use reports.• Assisted Quality department with HEDIS measure deep dive to support HEDIS audit and revenue at risk reporting.• Analyzed data sets and trends for anomalies, outliers, trend changes and opportunities and predicted future trends in cost, utilization, and performance while data mapping.• Assisted with research, development and completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.

• Streamlined communication between different roles, facilitating the identification of trends and thedevelopment of targeted training programs to enhance staff performance.• Collaborated with the Quality Department to provide immediate feedback on quality evaluations,effectively addressing inquiries and managing escalated issues to ensure swift resolution.• Oversaw Foundation Specialists, establishing performance objectives and monitoring progress, whilealso assisting with the generation and dissemination of productivity reports and key program metrics.

• Supervised a team of 29, effectively allocating daily tasks and managing successful completion, leadingto enhanced productivity and operational efficiency.• Conducted meticulous quality assurance for medication orders and adverse event submissions,ensuring timely and accurate processing, which improved overall service delivery.• Provided expert resolution to escalated issues and comprehensive education on insurance guidelines,contributing significantly to team knowledge and customer satisfaction.

• Designed and implemented Standard Operating Procedures, Work Instructions, and Job Aids,contributing to streamlined program operations and improved team productivity.• Conducted comprehensive quarterly reviews of program processes, identifying areas for improvementand facilitating necessary updates.• Worked to separate meaningful information from complex information through data analysis, verification, scrubbing, and root cause analysis.• Executed monthly case quality analyses and coordinated regular coaching sessions, enhancing staffperformance and promoting a culture of continuous learning and improvement.• Maintained exceptional quality control standards, achieving a 0% claims denial status and consistentlyexceeding daily case completion goals, further recognized by multiple organizational awards.