Patricia Dagg Email and Phone Number

Lead and support Pre-Implementation Audits. Collaborate with Benefit Services, Sales and Audit and Risk Management as needed ensuring they are demonstrated with the highest integrity contributing to the retention of existing accounts as well as the sales of new accounts. Support Open Enrollment driving accountability for high risk accounts helping to ensure coding accuracy and improve account satisfaction.Prepare comprehensive test plans and presentations to internal business partners and external consultants when required.Define, develop and execute comprehensive testing to validate the accuracy of benefit coding for performance guarantee and sensitive accounts.Assess test results, identify and implement opportunities to improve the testing process. Effectively plan and facilitate meetings and work groups.Mentor testers as needed sharing job knowledge and best practices.Support the Quality review for testing analyst collaborating on training needs based on identified trends. Identify opportunities and develop processes to streamline and enhance productivity during all phases of the testing process.

Perform detailed end to end claim processing audits for Performance Guarantee accounts. Analyze information on claims processing details pertaining to benefits, claims and payment policy guidelines. Collaborate with key business areas, audit leadership and management on findings making recommendations for process improvements.

Performed detailed quality review on associate’s research insuring first contact resolution for all provider inquiries. Provided motivational feedback to associates following up with workflow recommendations or corrective action as needed. Continuously take the lead role to design, implement and roll out innovative quality review processes related to Institutional, Professional Provider, unique pricing and group fee updates. Successful collaboration in the development, documentation, training and implementation of Provider Services, Provider Enrollment, Pricing and Payment Policy quality programs

Provided accurate responses to customers, for multiple products, provider types and specialties pertaining to claim processing and benefit inquiries.Educated providers on claims processing guidelines, claims coding, and medical policy guidelines.

Supervised and coordinated all activities for the teller line. Cash control and reconciliation. Provide outstanding customer service. Provided and ensured proficient transaction processing. Effective cross sales experience. Responsible for all operational process for the banking center pertaining to audits and security processes.