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Skills

  • Operational improvement
  • Prior authorization processing
  • Legal document interpretation
  • External consultant collaboration
  • Public speaking and presentations
  • Team management
  • Data monitoring systems
  • Budgets
  • Advanced presentation skills
  • Team building

Work Experiences

  • Collaborated with government representatives.
  • Achieved compliance across the Pacific Northwest in 2015.
  • Collaborated with system customers to determine their needs and deliver metric service.
  • Achieved unanimous approval for changes.
  • Chaired the Policy Review Committee.
  • Aligned changes with strategic objectives.
  • Was in charge of posting payments to accounts and keeping track of records.
  • Collaborated with legal, HR, and operations teams.
  • Authored and submitted 13 policy proposals.
  • Authored and submitted 3 policy proposals to executive leadership, helping secure organizational buy-in for changes that aligned with strategic objectives.

Summaries

  • Professional with experience verifying insurance benefits and generating appropriate patient documentation.
  • Insurance Verification Specialist with 2 years of experience explaining benefits and tracking coverage.
  • Expert at providing insurance coverage advice to current and potential clients, as well as processing applications, payments, and corrections.
  • Achieved a 46% reduction in compliance gaps.
  • Aligned revisions with industry standards.
  • Recognized on a regular basis for outstanding performance and contributions to the Miscellaneous industry's success.
  • Senior Policy Change Coordinator with 15 years of experience, dedicated to providing personalized, courteous service.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the program business.
  • Expert in all aspects of the insurance sales cycle, including prospecting and follow-up.
  • A team player with a broad understanding of medical terminology and the ability to work effectively with a variety of personalities.

Accomplishments

  • Coordinated with the project management office to ensure that policy change implementations were delivered on time, contributing to 31% above-target initiative completion rate.
  • Restructured internal reporting processes post-policy changes to ensure real-time updates on compliance, reducing review overhead by 53%.
  • Led the development and implementation of 5 policy initiatives that improved compliance with federal regulations, reducing legal exposure by 46%.
  • Facilitated 16 workshops for key stakeholders, ensuring uniform understanding and application of category, resulting in 77% improvement in operational efficiency.
  • Led cross-functional collaboration in re-assessing policy frameworks, enacting key revisions that reduced the risk of non-compliance by $4.
  • Ensured that all employees adhered to new policies by organizing comprehensive training sessions, which improved compliance rates by 83% within the past year.
  • Implemented a post-implementation audit procedure that identified 15 compliance gaps, leading to policy updates that improved adherence to regulatory mandates.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Assisted in the successful negotiation of policy adoption with program, resulting in favorable legislative changes at the local and state level.
  • Documented and resolved program which led to framework.

Affiliations

  • Society of Human Resource Management
  • Toastmasters
  • Association for Public Policy Analysis & Management (APPAM)
  • International Network of Crisis Mappers (INCM)
  • National Council on Public History (NCPH)
  • Association for Computing Machinery
  • American Medical Informatics Association
  • Public Relations Society of America (PRSA)
  • National Conference of State Legislatures (NCSL)
  • Institute for Public Relations (IPR)

Certifications

  • Certified Public Accountant
  • First Aid/CPR Certified
  • Lean Six Sigma Green Belt (LSSGB) by Ironclad Systems
  • Certified in Project Scheduling (PMI-SP) by standard
  • Project Management Professional (PMP)
  • Certificate in Public Policy Negotiation and Mediation by Cedar Works
  • Certified Change Management Professional (CCMP) by the Association of Change Management Professionals (ACMP)
  • Certified Policy Change Analyst by Northwind
  • Certified Public Accountant (CPA)
  • Government Regulatory Compliance Certification (GRCC) by Beacon Labs

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