Lori Dodge Email and Phone Number
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Demonstrated history of working in the insurance industry with extensive knowledge of improving, implementing, and identifying operational efficiencies. Key player in associate development to empower independent decision-making skills and provide new opportunities for growth. Expertly maintains company payment quality standards and determination to exceed claims processing goals from a pre- and post-pay perspective. Customer service professional, focused on the needs of stakeholders and driving strategic initiatives to move the company forward.Operations Management | Project Management | Team DevelopmentClaims Process | Strategic Planning | Customer Service
Navitus Health Solutions
View- Website:
- navitus.com
- Employees:
- 749
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Client Audit ManagerNavitus Health Solutions Sep 2019 - PresentAppleton, Wisconsin, United States
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Manager Of ConfigurationNetwork Health Wi Aug 2017 - May 2019Manager of ConfigurationGuide team to implement configuration updates to the QNXT operating system related to contract and benefit changes. Add new and renew employer groups in system according to current sales agreements. Engage employees and empower them to drive results through strategic planning and collaboration. Participate in product development activities to drive company values and promote new business opportunities.• Collaborate with team and department leaders to move Medicare claims processing segment from an outside vendor to in-house processing segment. • Quality focus on configuration processes. Partner with Quality Audit department to build program that identifies improvement opportunities to promote accurate benefit and contract system build.• Drive continuous improvement and organizational change within company based upon Lean Six Sigma principles. -
Provider Payment Integrity/Prepay Audit Operations ManagerHumana Apr 2012 - May 2017Green Bay, Wisconsin AreaProvider Payment Integrity / Prepay Audit Claims Operations Manager 2012 – 2017Engaged associates to maximize contribution and drive operational execution of business strategy. Promoted communication and collaboration to identify and implement process efficiencies, and perform system enhancements. Vendor Management Leader.• Led production teams, including vendors, through managing prepay inventory and identifying efficiencies, exceeding prepay claims processing goals by $54.2M.• Collaborated with team to automate and improve processes, reducing department’s administrative costs by $993K.• Implemented and maintained claims processing quality audit program, achieving 99% company financial payment expectation through quality focus auditing. -
Financial Recovery Frontline LeaderHumana Jul 2007 - Apr 2012Green Bay, Wisconsin AreaSupervised several teams to improve post-pay claims processing and review for company. Led Financial recovery Research, Customer Service, and Post-pay audit teams.• Project lead on continuous improvement process team to create and implement department production tool which moved inventory from databases to web based applications, allowing work to be completed more efficiently and increasing overall production.• Collaborated with dental partners, creating prepay claims audit process and monthly savings for the company.• Devised cross-training classes for associates to learn new products and platforms, expanding development and growth opportunities.
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Correspondence Team LeadHumana Oct 2005 - Jul 2007Green Bay, Wisconsin AreaCorrespondence Team Leader 2005 – 2007Assisted in development of team members to complete processing of provider correspondence inquiries from a post-payment perspective. • Partnered with supervisor in daily production activities, achieving team quality and performance goals. • Performed monthly audits and provided feedback, ensuring associate’s quality of work standards were met.• Identified process improvements and system enhancements, developing strategic initiatives for department.
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Customer Service Claims SpecialistHumana Nov 2003 - Oct 2005Green Bay, Wisconsin AreaResearched provider payment disputes submitted for claims processing to maintain or overturn original processing decisions based on applicable guidelines.• Explained payment processing details to providers, verifying claims were processed according to contract and member benefits.• Assisted with development of new associates, ensuring understanding of business objectives and procedures.
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Claims Processing SpecialistHumana Jul 2002 - Nov 2003Green Bay, Wisconsin AreaProcessed claims submitted by medical providers or members according to plan benefits.• Provided excellent customer service to providers and members through timely and accurate claims processing.
Lori Dodge Skills
Lori Dodge Education Details
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Business Administration And Management, General
Frequently Asked Questions about Lori Dodge
What company does Lori Dodge work for?
Lori Dodge works for Navitus Health Solutions
What is Lori Dodge's role at the current company?
Lori Dodge's current role is Client Audit Manager.
What is Lori Dodge's email address?
Lori Dodge's email address is lo****@****tus.com
What schools did Lori Dodge attend?
Lori Dodge attended University Of Mount Olive.
What skills is Lori Dodge known for?
Lori Dodge has skills like Customer Service, Management, Leadership, Project Management, Strategic Planning, Research, Team Building, Vendor Management, Business Process Improvement.
Who are Lori Dodge's colleagues?
Lori Dodge's colleagues are Carol Smith, Kimberly Olson - Steinhoff, Jayne Subak, Emma Lindberg, Thelma Salazar, Michael Malewicz, Brandon Danielson.
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Lori Dodge
Bartlett, Il
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