Senior Director Pre-Access
Current★ Directs a 180-person team in a contact center performing insurance verification and securing prior authorizations from insurance carriers on behalf of 72 acute care facilities. Manages a volume of 50,000 patient accounts per month and 100,000 inbound calls each year.★ Works with C-level executive leaders and other key stakeholders across multiple hospital systems.★ Prioritized prior authorizations ahead of the scheduling of procedures, substantially lowering claim denials and increasing SLA compliance by 35%.★ Reduced infusion-related claim denials by $6M each month by introducing a centralized infusion team and standardized workflow.★ Implemented technologies to automate manual processes, improving efficiency and productivity while enabling a 25% reduction in headcount.★ Streamlined front-end denial review, trending, and resolution process.★ Partners with the global operations team to ensure a seamless client experience. ☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲ABOUT MERCY HEALTH / ENSEMBLE HEALTH PARTNERSEnsemble Health Partners is a revenue cycle management company that serves the Healthcare industry. The company was acquired by Mercy Health in 2016.I also have an extensive history with insurance payer practices, including claims processing, appeals and customer service. This provides me with a well-rounded view of healthcare administration, which helps with creating a logical strategy.
