Peg Martino work email
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Peg Martino personal email
• Accomplished professional with extensive experience in the support and management of Healthcare initiatives and appeals programs• Assist Consumers and Providers with external appeals of an adverse Utilization Management (UM) decision by Health or Dental carriers’ denials pursuant to an Independent Utilization Review Organization (IURO)• Assisted Providers with complaints made against Health Insurance and Dental carriers pursuant to the Health Claims Authorization Processing and Payment Act (HCAPPA)• Developed an understanding of applicable statutes, regulations and bulletins to determine DOBI jurisdiction
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Semi RetiredRetired Dec 2019 - Present
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Health Insurance InvestigatorNew Jersey Department Of Banking And Insurance Dec 2013 - Dec 2019Assist Healthcare Providers and patients with appeals for against Health Insurance and Dental carriers pursuant to the Health Claims Authorization Processing and Payment Act (HCAPPA) and Independent Health Care Appeals program (IHCAP)Developed an understanding of applicable statutes, regulations and bulletins to determine DOBI jurisdiction. Gained expertise in the Appeals process both internal and external to Insurance companies. -
Healthcare Insurance Consumer AnalystNew Jersey Department Of Banking And Insurance Jan 2011 - Dec 2013Trenton, NjAnalyze policies and regulations for premium rate review and prepare for implementation of Affordable Care Act regulations as they pertain to carriers and rate reviewWrite RFPs and SOWs for grant projects and contractorsAct as the liaison and project manager for various consultant projects which includes tracking budgets, ensuring consultants and DOBI staff stay on target Assist with the creation and distribution of outreach materials describing the Affordable Care Act as well as NJ Protect, the internal and external health insurance appeals process, and New Jersey Health Insurance enrollment options Educate and advocate for NJ consumers on issues related to health care
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Board Of Trustees And VolunteerRonald Mcdonald House Central New Jersey 2007 - 2012Involved with fundraising, event planning, personnel committee and educating the local community about our mission.
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Department AdministratorRobert Wood Johnson Medical School Jan 2008 - Nov 2009New Brunswick, New JerseyCoordinated the efforts, research and clinical activities of 50 faculty members over 7 campuses, negotiating various contracts, budgeting, scheduling of programs, hosting monthly CME events, overseeing a residency program and Grand Rounds across all campuses. Established and reviewed clinical reimbursement policies with faculty and staff for optimal results. Oversaw and monitored the administration of NIH, CDC, State and Private Grants as well as GME funds.Prepared and monitored Monthly and Annual Budgets for each Division within Pathology and Laboratory Services.
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Director Of Rwj Health NetworkRobert Wood Johnson Health Network Jan 1996 - Dec 2008Successfully coordinated and executed RWJHN programs, including but not limited to, practice management, information systems, care management and reimbursement contractingDeveloped, implemented and administered a practice management service for over 30 physicians, increased revenue produced from practice management service by 20% for 3 consecutive years while incurring minimal additional costsAdministered a Multiple Employer Welfare Act (MEWA) Trust for RWJHN physicians to provide health insurance coverage at a discounted rate. MEWA grew to insure 1000 members in the first 24 monthsExpertly prepared annual operations budget including cost saving measures for approval by RWJHN Board -
Health Information Systems AdministratorNj Essential Health Services Commission Jan 1994 - Jan 1996Administered contracts with outside vendors to design, implement and deliver a claims pricing system to streamline the process for the administration of Charity Care patient reimbursement to hospitals throughout New JerseyImplemented a centralized electronic eligibility determination system to be accessed by hospitals, vendors and state employees
Peg Martino Skills
Peg Martino Education Details
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Healthcare Administration -
Non Profit Management -
Laboratory Institute Of MerchandisingMerchandising And Marketing
Frequently Asked Questions about Peg Martino
What company does Peg Martino work for?
Peg Martino works for Retired
What is Peg Martino's role at the current company?
Peg Martino's current role is Semi Retired at Retired.
What is Peg Martino's email address?
Peg Martino's email address is pd****@****ast.net
What schools did Peg Martino attend?
Peg Martino attended Thomas Edison State University, Fordham University, Laboratory Institute Of Merchandising.
What are some of Peg Martino's interests?
Peg Martino has interest in Networking, Social Services, Children, Volunteering, Yoga, Learning, Education, Disaster And Humanitarian Relief, Health, Charity Work.
What skills is Peg Martino known for?
Peg Martino has skills like Physician Billing, Medicare Eobs, Non Profits, Insurance, Healthcare, Research, Budget, Health Insurance, Claim, Healthcare Management, Managed Care, Healthcare Information Technology.
Who are Peg Martino's colleagues?
Peg Martino's colleagues are Emily Hillis, Steve Jankowski, John Weinberg, Catherine Elledge, Jerry Woods, Bruce Duhe, Jaci Graham.
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Peg Martino
Monmouth Junction, Nj1umdnj.edu -
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