Michele Ring Email & Phone Number

Madison- Dean Health Plan

* Collaborate with business, project and technical customers to deliver expected system configuration results* Evaluating production and process impact on system changes* Coordinating, tracking and implementing product updates and regulatory changes within the system in close interaction with Product, Compliance and Medical Affairs team* Ensuring all benefits configuration is aligned with Certificate, Schedule of Benefits, Medical Policies and regulatory requirements* Assisting with system maintenance and ongoing support* Performing training as needed on processes and configuration related to functional areas assigned and serve as a subject matter expert for training in operational departments* Assisting with installing, integrating and testing system upgrades including work with pertinent vendors and tools* Serving as a team resource for technical and operational questions, concerns, and remediation that requires research and/or changes to configuration generally discovered through testing or claims processing* Identifying and detailing function-specific configuration needs* Communicating functional configuration designs to leader; assisting in prioritization* Performing manual data loads and assisting with automated files and interfaces* Maintaining and updating technical workbooks and process documentation and communicating configuration design to down-stream teams* Assisting with developing and completing interfaces, required reports and related analysis as needed* Understanding coding and modifiers in order to ensure configuration supports the most current version of ICD=9/ICD 10, CPT, and HCPCS codes in agreement with government payers and commercial insurance standards to guarantee HIPAA compliance. Working cross-functional with production teams to analyze code sets and meet requirements of pricing contracts and product configuration* Ensuring all reimbursement is based on the provider's contract and status.

Madison, Wisconsin Area

* Review request for new plans to be compliant with HCR and the ACA requirements effective 01/01/2014, as well as PPIC benefit requirements* Review the Summary of Benefits (SOB) and Summary of Benefits Coverage for each plan and work with the Sales and Marketing staff. * Work with the Compliance Officer to create the format and language on the SOB and SBC for the coming year* Research upcoming year Federal Regulations, i.e. Maximum Out of Pocket (MOOP) limitations, ACA changes and updates* Research and resolve claim issues* Attend weekly meetings with Application Support staff to resolve configuration errors and changes* Attend meetings as required such as New Product committee* Assist Coding, Claims and Health Service staff regarding benefit set up and limitations as necessary* Create test claims within the testing environments to validate plans and benefit changes prior to implementing in production* Work claims pended to Configuration, CRM requests and emails* Assist claim staff in resolving accumulation errors in Tapestry* In the test environment create a test plan for new product and plan designs requested by the Sales staff* Run reports after benefit updates to analyze the need to re-run claims affected by the change* Validate that all plans built have a corresponding benefit document available for all staff* Worked on team that created the Benefit Plan Template that is a detailed document for all benefit plans built in the Tapestry system* Work with Actuarial and Sales staff on new benefit plan builds* Work with CMS team to create documents for the upcoming year QHP filing for the coming years Individual ACA plans on and off the exchange* Responsible for the QHP Crosswalk and Plans and Benefit Template for Individual ACA plans* Assist with any filing errors from past years filing or the current years filing* Work with management on Product Development and requirements for a benefit modification versus a custom benefit plan.

Madison, Wisconsin Area

Audit top dollar accounts which requires resolution of contractual and billing issues for DME accounts. Interact with providers, insurance companies, HMO, Medicare and Medicaid to resolve open invoices. Confirming new DME orders, RX and CMN’s are current and accurate and are ready for billing. Participate in training forums for new software conversion.

Dean Health Plan

Consulting with Dean Health Plan with reconciling their new system Metavance for activity on September, 2010 to December 2011.

2009 to 2011Offers a range of consulting, construction and engineering services, providing a variety of renewable energy development and environmental remediation solutions.Accounts Receivable Supervisor, FinanceLed a team of four in managing accounts receivable processes including, contract review, cycle billing, and new project/contract set up. Conducted monthly, quarterly and yearly reporting of accounts receivables. Review bankruptcy data to report on clients filing bankruptcy, filing forms and documenting.Collaborated with management and project managers to design and implement tighter contract set up guidelines and billing procedures;Significantly improved SOX compliance measures and minimized audit issues.Billing formats supported project manager and individual client needs and eliminated time consuming client follow up.Thoroughly investigated to resolve accounting issues associated with a neglected cash suspense account with unidentified deposits from up to three years prior; Unraveled situations reducing the account balance from $200k to $16K in six months.Designed a "go forward" process to eliminate the possibility of further issues. Initiated cross-training measures within department, designing user friendly, accessible training materials, achieving a more flexible, competent and responsive team.Established tracking system and follow up procedures to collect on > 90 days, outstanding AR accounts.Assisted with the implementation and testing of organization's ERP system (Deltek Costpoint); worked with team members individually to ensure optimal use of system tools.

Madison, Wi.

From 2007 to 2009 oversaw the implementation of new software system, preparation for annual and monthly board meetings and contract analysis and negotiation activities with insurance companies for dental and orthodontic benefits.Billing Manager from 2001- 2009 in which I created the Central Billing department with responsibilities of accounts receivable, customer service, training, payment reconciliation and contracting functions, job analysis, recruitment, employee develoment, and performance management.

Managed software systems through specialized application support, system configuration and ongoing technical support; developed system testing processes, role-based set up, training, reference materials, and go live success plans.Developed index of contracts and fee schedules as well as system reports that define formulas and show report data index.As a member of the organization's leadership team, provided functional area expertise to colleagues and collaborated to solve problems and positively affect the direction of the organization.; Managed team members in AR, customer service, registration, insurance processes, payment reconciliation and contracting functions, coordinating and facilitating job analysis, recruitment, employee development, and performance management. Coordinated accurate and timely input of information, collection of accounts receivable from all payors.Involved team members in centralizing the billing function, establishing individual processes and relative ownership, and allowing for clearer claims information and a better patient experience.Designed training materials and facilitated training program on existing software application increasing the accuracy and comfort levels of billing and clinical staff. Visible hands on managing of staff and processes while promoting a continuous learning environment through monthly and weekly meetings throughout the organization.Communicated systems, business and coverage updates promptly and provided training to all levels of the organization.

Multi-specialty, integrated healthcare delivery system with a network throughout Southern Wisconsin.; Responsible for the documentation and assessment of current workflows, system usage, software and hardware for all business teams for the Epic conversion.Ensured a successful business team system implementation by establishing workflows, practice scenarios and support plans, as well as, developing curriculum and training materials.Tested Epic system modules, communicated outcomes and made recommendations for change.Trained business office staff on Epic Resolute including in basket and in basket workflows

Managed 50 staff members in the customer service, financial services, corporate training and support services teams including accounts receivable, registration, customer service, training, collection, legal affairs, billing system and insurance functions using the Meditech system.Oversaw the operations of the Financial and Customer Service call centers that provided service to providers, patients and insurance staff. Implemented processes to verify that the highest level of customer service and production levels were met.Managed staff performing accounts receivable, insurance and registration functions for accurate and timely input of information and collection from appropriate parties.Hands on management style with working alongside staff when necessary and having an open door policy while creating a positive learning and working environment.Managed performance reports and statistical analysis for monthly reportingServed as department liaison for the business office and worked with other departments for special projects. Developed and successfully implemented several payment programs as well as call center and corporate training programs for Meditech enhancements. Served on committee to reorganize the business office from three separate departments into one with comprised of two teams.

Mba, Organizational Development

start date for online classes of July 2, 2012.

Project Management

Executive Education: Master Certificate program - Project Management Planning Scheduling & Control Project Leadership Communication.

B.S., Business Management

General Studies