Introduced an effective communication platform for the Denials Department that was implemented across the financial department Collaborated with doctors, case managers, and nurses to overturn denials Researched and analyzed denial data and coordinate denial recovery responsibilities Identified, analyzed, and researched frequent root causes of denials and develop corrective action plans for resolution of denialsPrioritize activities to work overturns in a timely manner to alleviate untimely filingsIdentified and pursued opportunities for improvements in denial performance Researched, responded and documented insurer and patient correspondence/inquiry notes regarding coding coverage, benefits, and reimbursement on patient’s accounts

Resolved referral, precertification, and/or prior authorizationSupported insurance specific plans requirements for all commercial, government and other payors across hospital (inpatient & outpatient), ED, and Clinic/ambulatory environmentsAssisted with pre-appointment insurance review (PAIR) and denial recovery functionsProcessed precertification for workers compensation/third (WC/TPL), managed care and HMO accounts

Planned, Scheduled and Coordinated Career Fair and Lunch & Learn Events; Participants hired were 33% for healthcare, 40% for a local bakery, 17% for construction Assisted with A/P with a budget of $4 millionHelped with budgeting and savings plans to yield 100% applicant approval for Individual Development Accounts(IDA) for houses, businesses, and educationHelped applicants report goals and register for selective service; 20% of applicants earned certification via National Center for Construction Education and Research (NCCER) Created a strategy to best align these assets and needs with community partners and service providersRecorded all resident information in case management softwareCreated a community engagement plan that educates residents about programsCreated and implemented a marketing plan to effectively advertise programs and engage residents in programmingTracked participation and outcomes from the programsIdentified and addressed resident barriers to financial stability or successful relocationAssisted 14 entrepreneurs with “Start-Me” program; business development, budgeting, action plans and forecasting with a 10% business applicant increase for 2018 and a 25% increase for 2019 business participation.