Robin Satchell Email & Phone Number

Tallahassee, Florida Area

Moved into this position 9/I5/14. I am so excited to return to work in a position that fulfills my desire to help those in need!In 1992, CMS physicians created the We Care Network under its charitable 501(c)(3) organization, the CMS Foundation. Today, more than 300 volunteer physicians provide donated specialty medical care, and over 40 dentists provide dental care, to low-income, uninsured residents of Leon, Gadsden, Jefferson, and Wakulla Counties. In addition to our volunteer physicians and dentists, all four hospitals participate, along with most ancillary providers in our community, including imaging services, home health care, and durable medical equipment. Since its inception, the We Care Network has donated over $55 million in medical and dental care and over $5 million in 2013.

Tallahassee, Florida Area

Contacting pharmacy and medical providers in order to verify products dispensed, Contacting labelers for detailed information regarding disputed items and providing claim level within one week of request.Researching disputed pharmaceutical products to accurately prepare rebate resolution proposals.Completing required productivity tracking reports.Assisting with accurate compilation and mailing of quarterly invoices and late letters.Interacting with internal and external customers to accomplish goals, making calls and working on the computer to research and analyze disputed data on drug rebate claims, then negotiating with drug manufacturers to fairly and accurately resolve the disputes. Demonstrated ability to communicate effectively both verbal and written with clients and stakeholders, such as medical and pharmacy providers, drug manufacturers, etc.Strong analytical ability and critical thinking skills, and an understanding of how to ask appropriate follow-up questions to get the data needed.The ability to negotiate effectively with manufacturers, and to understand when it is time to request help from a 3rd party. Meticulous attention to detail, with the ability and desire to keep track of where you are in the process and follow through until completed.The ability to establish and maintain positive and collaborative relationships with coworkers, clients, members, providers, and customers.The ability to abide by policies, including maintaining attendance to support the required quality and quantity of work, maintaining confidentiality, and complying with the Health Insurance Portability and Accountability Act (HIPAA).Solid computer skills, including working with windows-based applications,

Florida

Assist Medicaid Waiver providers with the following tasks:1-Organization of required documentation and records according to medicaid policy guidelines2-Medicaid audit preparation3-Medicaid audit submission and follow-up4-Assistance and support with preparation for Medicaid Administrative Hearings

Tallahassee, Florida Area

Educational and hands-on experience investigating fraud/abuse issues and trends relating to all home and community-based services waiver programs. Developed recommendations for the Agency to address audit findings that are cost effective and efficient in promoting the reduction of fraud and abuse. Recommended policy revision, worked directly with a former Inspector General in this effort. Developed and maintained relationships with providers. Communicated with providers and persons outside the organization, represented the Agency to customers, the public, other governmental agencies, and external partners. Researched and developed standardized forms for each program audited. Planned, organized and conducted comprehensive investigations in accurate and timely manner. Managed the assigned caseload, recommended administrative remedies, and referred certain cases for criminal investigation. Conducted prepayment reviews and interviewed Medicaid providers and recipients. Participated in coordinated on-site investigations of providers and recipients. Recommended improvements and assisted providers with implementation of tools to increase their efficiency; meet policy requirements and minimize waste. Prepared accurately written findings and recommendations in approved report format as required for issuing overpayment and recoupment notifications. Applied mandated sanctions, where applicable. Tracked delivery of notifications, and deadlines. Testified in formal administrative hearings. Prepared final orders and closing reports. Assisted in training of new analysts.

Tallahassee, Florida Area

Performed disability assessments relating to educational, personal and vocational training needs. Performed assessments under contracts with the Departments of Vocational Rehabilitation, Children and Families, and Veterans Affairs. Prepared detailed evaluation reports to be utilized by counselors. Performed contract management responsibilities. Trained and supervised staff of 12 employees working with persons with disabilities in the following areas: disability awareness and person-centered service provision; adherence to the home and community-based services Medicaid waiver for persons with developmental disabilities and aged and disabled adults. Participated in multiple quality assurance reviews, completed comprehensive psychosocial & functional evaluations, collected information, analyzed data and maintained the database regarding populations served, quality control and assurance, performed interviews, presented program details and provided information to local and State boards on monthly or quarterly basis, evaluated program goals and benchmarks and implemented adjustments to facilitate increased productivity and meet program standards while keeping all programs on budget. Performed public relations functions, including public speaking while advocating for individuals and the agency. Maintained up-to-date knowledge of all available assistance programs, including Medicare, Medicaid and other available community resources.

Bs In Rehabilitation Services, Disability & Aged Medicaid Waivers, Case Mgmt, Statistics, Evaluation, 4.0

B.S. in Rehabilitation Services

Bs In Psychology & Human Services, Psychology

A.A in Psychology & Human Services