Michael Sarnese Email & Phone Number

Philadelphia, PA, US

Blue Bell, Pennsylvania, US

Blue Bell, Pennsylvania, US

• Lead the out of network claims negotiation team including the development and launch of a consumer medical bill advocacy product.
• Streamlined end to end negotiation process resulting in a $0.9M savings increase on book of business for fiscal year 2018.
• Product leader for Consilium’s Reference Based Pricing product responsible for ensuring accurate Medicare pricing is provided to all clients.
• Created Consumer Medical Bill Solutions website content to highlight competitive advantage and appeal to target customer base.
• Leveraged existing medical charge data to direct patients to quality medical care at the most affordable price.
• Collaborated with the customer service department to ensure process compliance and expedite the settlement process.

King Of Prussia, PA, US

• Oversight and direction of proprietary claim evaluation software program to ensure optimum claim routing efficiency.
• Evaluated software algorithms within Consilium’s proprietary application to ensure efficient claims routing was at its maximum functionality.
• Led a major initiative to obtain direct contracts with healthcare providers who had previously declined single case negotiation.

King Of Prussia, PA, US

• Led a staff of two claims negotiators and one claims analyst responsible for the disposition of single case settlements for out of network claims from a variety of insurance companies, third party administrators and.
• Facilitated the distribution of high dollar claims to each team member based on the claim complexity, dollar amount and skill of negotiator.
• Spearheaded development of new hiring process to include a testing policy and training manual.

King Of Prussia, PA, US

• Responsible for negotiation of out of network medical claims for national health plans, third party administrators, HMO’s and Taft-Hartley funds.
• Audit out of network claims to ensure billing accuracy and errors in accordance with NCCI guidelines.
• Developed successful negotiation strategies to secure largest discounts.
• Trained new negotiators on the most effective negotiation methods.

• Responsible for perfecting a network commitment from physicians of different specialties.
• Averaged 20-30 new physicians per month.
• Trained new department employees on most effective recruitment methods.

Provided construction services in various capacities depending on the need of the company.Led a construction crew in the completion of various jobs for luxury home builders.Responsible for managing construction materials to ensure adequate supplies for job completion.

Woonsocket, Rhode Island, US

• In charge of filling patient prescriptions and managing in store supplies.
• Worked with insurers to ensure proper coverage for CVS customers
• Responsible for keeping online records of patient prescription and insurance coverage.