• Administer and manage leave programs, including short term disability and maternity, with FMLA• Collect records and file all necessary documents electronically in a timely manner• Communicate with, and train, BU HC teams and employees about leave program • Complete processing of Worker Compensation for assigned East Region• Assist with coverage of East & West Region

• Administer and manage leave programs, including updating and improving system• Collect records and file all necessary documents electronically in a timely manner• Communicate with BU HC teams and employees about leave program • Complete processing of Worker Compensation for assigned East Region• Assist with coverage of East & West Region

• Administer and manage leave programs, including updating and improving system• Collect records and file all necessary documents electronically in a timely manner• Communicate with BU HC and employees about leave program• Primary focus on California leaves related to both Federal and State • Complete processing of Worker Compensation and Military leaves for California and Midwest territory• Assist with coverage of Midwest territory

• Prepare certification renewals, and required modifications to Managed Care filings• Manage new certifications, renewals, required mailings, reporting requirements, data calls, etc• Track changes to applicable laws, regulations, and jurisdictional requirements• Proactively communicate requirements, deadlines, filing needs, and other concerns• Participate in coordinating state audit procedures for case management and/or medical bill review• Assist the VP, Partner Relations with various network analyses• Ensure compliance management for all Conduent state managed care plans

(contracted services to support GE Aviation)Client Focus:• Support services for Aviation Industry Client at two, (2), locations via interaction with Client Managers• Determine needs, solicit feedback and implement solutions to address Client issues• Analyze workflow and assignments to ensure operations run efficiently• Identify process improvements, drive execution, utilizing metrics and quality functions• Establish work schedules to minimize overtimeContinued…HR/Team Focus:• Coach and Mentor to a team of 35+, including Goal Setting and Career Development Planning• Annual Reviews and Performance Improvement Plans• Staffing – Interview/Selection/Placement, Onboarding/Orientation, and Training• Process payroll and track PTOGeneral Management Focus:• Project Management• Procedure and Policy – Development and Implementation• Metrics and Quality – Lean Six Sigma Yellow Belt

• Create/Update/Maintain provider CAQH profiles• Apply for Medicare and/or Medicaid numbers• Payor Credentialing & Re-credentialing for all provider applications** For multiple carriers such as Blue Cross, HealthPartners, Medica, Medicare & State plans.• Creating/Updating/Maintaining CAQH profiles.• Applying for Medicare and/or Medicaid #’s.• Payor Credentialing & Re-credentialing for facilities, including clinics and hospitals*.• Payor Credentialing & Re-credentialing for all provider applications*.* For multiple major carriers such as Blue Cross, HealthPartners, Medica, Medicare & State plans.

• Expedite responses to audit requests for RAC, MAC, MIC, CERT, etc.• Perform quality control audits relating to document imaging for facility EHR.• Created tracking and metrics system related to audit requests, decisions, and success rates.• Audit active patient records for required provider documentations for all verbal & telephone orders.

• Creating/Updating/Maintaining CAQH profiles• Applying for Medicare and/or Medicaid numbers• Project Management – Policy/Procedures• Payor Credentialing & Re-credentialing for providers and facilities, including clinics and hospitals** Includes all provider types; * For multiple major carriers including Medicare & State plans

• Support Regional Director, Medical Director with administrative items.• Provide excellent service to injured employees and employers.• Medical records, billing, appointment coordination.• Practice Management.• Project Management.Completed duties for both positions from November 2010 – August 2011, until workload for PCS role grew to full time. ACS role was also full time 08/11.

• Provide excellent software support service to insurance agencies and their agents.• Troubleshoot insurance rating software issues quickly and efficiently.• Enthusiastically working as part of a team to provide the best service possible.

• Accurately assist Target team members with all leave of absence issues nationwide.• FMLA, Short/Long Term Disability & Worker Compensation benefits/laws for all 50 States.• Document data accurately and in detail.

• Re-vamp filing system for personnel files.• Facilitate & coordinate compliance related trainings.• Develop On-Call Networking Pool to fill urgent shift openings.• HR & Generalist duties: new hires, discipline, terminations, benefits, payroll, compliance tracking.• Supervision of On-Call Pool and 30+ PCA's – includes scheduling and all supervisory duties.

• Procedure development for several key office positions• Develop filing system for personnel & credentialing files• Worked w/insurance broker to save 10% on health insurance benefits to clinic employees• Assist Executive Director with letters, memos, meeting minutes, etc• Board meeting preparation, mailings, communication• HR: new hires, discipline, training, terms, insurance, payroll• Credentialing of practitioners for multiple commercial carriers, Medicare & Medicaid• Fundraising and grant writing/seeking