Linzi Driver, A-Cspo Email & Phone Number

Tampa, Fl, Us

Saint Louis, Mo, Us

Health Plans Account Manager - National

Tampa, Florida, Us

Recruited by executive leadership to join USIN to support the creation and expansion of the USIN National Provider Outreach Team. Worked directly with senior executive leadership and General Counsel to conduct interviews and to develop the goals, training and processes necessary to fit within the ASO and Large Insurance Group contract limits. *USIN is a benefit program to educate providers and members on diagnostic alternatives for cost savings, decreasing PMPM and out of pocket expenses. Built relationships that nurtured provider partnerships and sought broader value-based business opportunities that supported the local market strategies.Significant ContributionsManaged eight field liaison representatives nationally to build and maintain provider relationships for Commercial and Medicare Advantage plans in 15 market regions; supported three million members, 13,000 facilities and 40,000 providers. Created quarterly PowerPoint presentations and presented to partnered Vendor, Market and Finance directors; highlighted market trends, progress, barriers and impactful changes. Collaborated with National IDS and hospital groups to build stronger relationships resulting in better experiences for membership population. Partnered with ancillary imaging centers to cohesively cross-market our PR and Outreach teams, thus preventing redundancy.Managed key provider relationships and was accountable for critical interface with providers and business staffPrepared, analyzed, reviewed, and projected financial impact of larger or complex provider contract impact and trends.

Louisville, Kentucky, Us

• Simultaneous Project Management of Health System issues with multi-million-dollar impacts• Effectively leverages resources to create exceptional outcomes• Direct point of contact for provider resolutions – claims, demographics, education, process improvements• Create and deliver tailored provider educations In-Services to provider groups and Hospital Health Systems – IDS• Run and analyze Modeling for contract rate negotiations – UB and 1500• Management of Medicare and Medicaid Credentialing status issues and resolutions• Maintenance of Medicare, Medicaid and Commercial lines of business – On and Off Exchange• Maintenance of ASC Grouper lists – (1-9 and 1-56)• Created annual Adequacy and Access national reports for HMO lines of business• Liaison for third party vendors with impacts to providers – Beacon, US Imaging, HealthHelp• Strong investigative and diagnostic data mining• Calculate and load Charge Masters and Escalators for hospital and Ancillary providers• Create Directors and VP AdHoc reports• Extrapolate data for complete provider impact and Insurance financial liability, by line of business• Identify contractual limits and suggest Amendments as needed• Execute provider Addendums and Settlements PRN• Maintain Hospital and Provider rosters end-to-end loading• Identifying and implementing ROI Trend Benders• Rectify claims and contractual disagreements with contract language and legal teams• Execute Business Case Justification for Physician and Hospital Settlements• Five years’ experience leveraging multiple databases e.g. Access, EDW, and proprietary systems• Deep understanding of compliance trends impacting all facets of Healthcare, including the Affordable Care Act• Hands-on experience of Healthcare management from the business, hospital, physician, vendor and patientstandpoints• Deep understanding of claims/revenue cycle experience – Overpayments and Underpayments

Louisville, Kentucky, Us

• Contractual and CMS Compliance assurance• Proactive in Policies and Procedures resolution • Strong investigative and diagnostic data mining• Hands-on experience of Healthcare management from the business, hospital, physician and patient standpoint, from the clinic setting to national size clients• Deep understanding of compliance trends impacting all facets of Healthcare, including the Affordable Care Act• Collaboration internally and externally to develop tools and processes for intended resolution• Simultaneous Project Management of multiple projects• Five years’ experience leveraging multiple databases e.g. SQL, Access, and proprietary systems• Developed automated commission payroll processing• AdHoc Excel reporting, produce advanced pivot tables• Identifying and implementing alternative strategies to achieve financial resolution• Maintain documentation and reporting of trending data issues• Resolution of Payment Discrepancies• Decreases duplicity to decrease project timelines

Miami, Fl, Us

Calculations of commission payments, Respond to email Audit investigative requests, Locate Company Sales Plan Documents that support denials of said Audits, Collaboration to implement process changes to decrease error reporting, Point of Contact for External agencies and sales agents, Resolution specialist for external accountants for agencies, Creation of CMS compliance actions, Access Report creation and running, Agent Statement creation and reporting, Bank reconciliation reporting, Systems maintenance of revenue payout, IT collaboration of calculation changes/compliance

Nashville, Tn, Us

Healthcare system analysis of contract compliancy or payment errors, Creation of correspondence to external Insurance companies and follow up phone calls, Identify system limitations vs. Contractual changes not recognized due to billing errors or other, Insurance contract comprehension and application to facilitate accurate system modeling, Collect and report trending of Non- compliant issues to lead, CMS regulations and follow up reporting to team lead, Organization of High Dollar claim resolutions

Verification of Benefits and collection of co-payments, Check in patients expeditiously, Set up payment schedules for billed claims, Excellent customer service in unique and stressful situations, Team coordination to accomplish a task fast and efficiently trained, EMTALA and First Responder Trained, Referral to State Assistance Programs for the uninsured

Radiologic Technology/Science - Radiographer

Education record

Diploma, All Required