Lynelle Thon Hall Email & Phone Number

Seattle, WA, US

Seattle WA

• Facilitated development of standardized work processes and flow diagrams for all key Medicare enrollment and financial reconciliation processes.
• Established user requirements in the processing database and developed criteria to validate input.
• Collaborated to develop and improve performance metrics and monitoring programs across functional areas to ensure performance is meeting or exceeding targets.
• Performed root cause analysis to identify problems and coordinated improvement initiatives.
• Developed, documented and maintained department policies and procedures to ensure compliance with federal and state guidelines.
• Actively participated in departmental readiness preparation following releases of new Medicare regulations/guidance.

Seattle WA

• Maintained demographic and health status records for 60,000+ members enrolled in Medicare and Part D product lines.
• Reconciled data and payment variances on daily, weekly and monthly cycles.
• Documented key process steps and cross-trained coworkers.
• Maximized accuracy of records and optimized capitation payments by reconciling monthly membership and payment files.
• Served as the primary contact with pharmacy benefit management (PBM) to effectively meet error resolution on eligibility and Low Income Status drug claims.
• Participated in process definition and implementation groups for major system integration and was selected as the lead subject matter expert in my peer group.

Seattle WA

Medicare Advantage Enrollment processes, maintenance, records management and customer service.