Vern Wright Email & Phone Number

Greater Philadelphia Area

Philadelphia, Pennsylvania

- Oversaw and managed compliance activities with a focus on supporting Health Partners Plans’ compliance program- Guided and collaborated with operational areas to ensure compliance with regulatory and corporate functions- Facilitated audit planning and determine scope of audits based on research of Medicare guidelines and annual risk assessment- Lead the.

Philadelphia, Pennsylvania

- Maintained oversight of operational areas to ensure compliance with Medicare guidelines and departmental processes- Developed monitoring tools and guides to utilize for the monitoring of Medicare operational areas- Collaborated with operational areas to identify potential or actual risk and employed methods to mitigate risks and address any deficiencies.

Greater Philadelphia Area

- Provided leadership, training, mentorship, and motivation to a team of Appeal Management Coordinators- Monitored daily reports, created/revised work procedures, and conducted quality reviews- Distributed and delegated tasks to team members in order to achieve the daily goals of the department- Assisted in educating providers and resolving compliance.

Greater Philadelphia Area

- Reviewed requests for reconsiderations and provider inquiries- Identified and corrected quality issues relating to the reconsideration decision- Applied Medicare regulations in determining the appropriate response and action required for provider reopening requests- Closely reviewed records and applied appropriate Medicare regulations to make.