Travis Nutter Email & Phone Number

Louisville, Ky, Us

I work within the Provider Reconciliation Program with assigned providers to process submissions of Medicare Risk Adjustable shadow files (claims files) and ASM (Alternative Submission Method) through our reconciliation model and open HCC analysis to close gaps. •Led multiple initiatives for program improvement, including creation of dashboards using Power BI. •Managed and oversight of automation projects to streamline processes within the Provider Reconciliation Program, including creation of spreadsheets autonomously that were manually created, file intake, submission results, etc. •Conducted root cause analysis with providers to identify issues within the claims data flow processes.

Louisville, Kentucky, United States

I developed business processes to ensure successful submission and reconciliation ofencounter submissions to Medicare. Ensured encounter submissions met or exceeded all compliance standards via analysis of data and developed tools to enhance the encounter acceptance rate by Medicare.•Created operations dashboards using Power BI, these were used to monitor trends in encounter acceptance.•Looked-for long-term improvements of encounter submissions processes through means of data analysis. Documented process steps for error corrections, to help ensure data integrity for claims errors.

Louisville, Kentucky

Reported to the VP of Revenue Cycle. In this position I monitored terms and contracts, as well as billing processes and authorization processes. I assisted with program and team development while in this role. •Gather information and documents to complete credentialing applications with health plans and maintained Managed Care agreements in the contract management database.•Ensured that claims were processed correctly and verified correct rates and/or billing codes. Worked with Claims pricing, overpayments, and reimbursements.•Launched and assisted with creation of the authorization team (HOMCAT). Participated and assisted with document creation as well as performing authorizations to assist with standardizing procedures.

Louisville, Kentucky

Audited paid claims for overpayments using various techniques including systems-basedqueries and specialized reporting.•Performed collection activities to ensure the recovery of overpayments and negative balance accounts. •Worked closely with contract managers to identify and correct contractual issues, interpreted provider contracts as they related to overpayment opportunities and compliance. •Conducted moderately complex case research and resolution for projects.

Lagrange Ky

Investigate medical claims and data to identify overpaid and/or incorrectly paid claims andinitiate the recovery of money for clients as well as performing extensive research in client systems. •Development and upkeep of training manuals and documents for the CAQH project and guides to help new Auditors follow a standardized way of auditing. •Helped develop skills of new auditors, including review of daily work and reporting up. •Ensured 100% quality is met by all employees by performing and implementing Quality Control and Report reviews.