Patrick Merkel Email & Phone Number

Danville, Pennsylvania

Direct the Government Programs Operations performance and compliance for three legal entities of Geisinger Insurance Operations (GIO).Supervise the Part D Reconciliation process and the risk adjusted payments from Government partners, SPAP contracts and confidentiality agreements.Manage the Medicare Reconciliation Team, member documents, and Government partner reporting.Oversee core claims system configuration testing.

Danville, Pa

Responsible for analytics and reporting of all Prescription Drug Event (PDE) related transactions required by Centers for Medicare and Medicaid Services (CMS). Calculate monthly general ledger accruals for the CMS Part D settlement.Developed a process that projects the annual Medicare Part D Reconciliation of $264 million in drug costs for Low-Income Cost Sharing, Reinsurance, Risk Sharing and Coverage Gap within a .0% variance.Manage all Plan to Plan and Coverage Gap Discount activity including Rx manufacturer payments and dispute resolution, plan to plan payables and receivables.Oversee all CMS PDE audits and Acumen PDE analysis, reporting and responses.Identify, research and resolve rejected PDEs, Medicaid Rx Encounter records and Financial Information Reporting (FIR) transactions.Maintained a 99.9% acceptance rate for PDEs and Medicaid Rx Encounters since 2012.

Nanticoke, Pa

Taught undergraduate Management, Marketing, Business, Human Resource Management, and Business Mathematics courses.

Wilkes-Barre, Pa

Managed the weekly and monthly production, distribution, and ongoing maintenance of availability and performance metrics.Tracked SLA’s (Service Level Agreements) with regard to system availability and bill processing statistics, detailed transaction analytics and incident management trending.Created daily, weekly, monthly, yearly, thirteen (13) month trending, and ad hoc reports.Maintained an internal website with product performance data.Facilitated a Daily Ticket Review meeting with the Problem and Vendor Management groups.

Wilkes-Barre, Pa

Created and conducted technical training classes on the wireless industry and ALLTEL’s wireless billing process.Facilitated Subject Matter Expert (SME) led training classes.Created technical training manuals and end user training materials.Evaluated and updated existing training documentation.Performed training needs analysis.Maintained multiple project tasks within an integrated project plan.

Master Of Business Administration (Mba), Management / Marketing

Bachelor'S Degree, Marketing