Description
Career Summary MORE THAN 30 YEARS AT ASSURANT HEALTH/FORTIS/TIME INSURANCE COMPANY. EMPLOYMENT ENDED DUE TO COMPANY CLOSING. POSITIONS HELD: CODING REVIEW ASSOCIATE/PHYSICIAN AUDIT EXAMINER, HEALTH CORRESPONDENT/APPEAL RESOLUTION SPECIALIST, MEMBER SERVICE REPRESENTATIVE, PROJECT COORDINATOR, CORPORATE COMMUNICATIONS ASSISTANT, BENEFIT ASSISTANT, DATA ENTRY CLERK, AND CLOSE CLAIMS CLERK. Accomplishments and Career Highlights CREATED A PROPOSAL AND PRESENTED IT TO OUR HUMAN RESOURCES DEPARTMENT SHOWING COST SAVINGS AND OTHER POSITIVE IMPACTS HAVING EMPLOYEES OF ALL LEVELS AND IN MULTIPLE DEPARTMENTS WORK AT HOME FULL TIME. THIS CONTRIBUTED TO THE SUCCESSFUL IMPLEMENTATION OF THIS PROGRAM. MAINTAINED 98-100% MONTHLY QUALITY AUDIT RESULTS BY OUR AUDITING DEPARTMENT WITH THE LAST 6 YEARS WORKING AT HOME FULL TIME. SUCCESSFUL MEETING WITH OUR CORPORATE EMPLOYEE BENEFIT DEPARTMENT TO INCLUDE FULL COMPANY SPONSORED BENEFITS TO THE DEPENDENT CHILDREN OF EMPLOYEES WHO WERE THEIR LEGAL GUARDIAN. MANAGED AND COORDINATED OUR TIME INSURANCE MATCHING GRANT PROGRAM. THIS INCLUDED BUDGETING, RECORD KEEPING AND BALANCING OF THE FOUNDATION CHECKBOOK. COORDINATED AND FACILITATED MONTHLY MEETINGS WITH SENIOR MANAGEMENT AND EXECUTIVE BOARD MEMBERS. MADE CLAIM DECISIONS OUTSIDE OF THE GENERAL SCOPE OF RESPONSIBILITIES AFTER RESEARCHING MORE COST EFFECTIVE AND BETTER STREAMLINED WORKFLOWS. PRESENTED SOLID RESULTS TO HIGH LEVELS OF VARIOUS DEPARTMENT HEADS WHICH CONTRIBUTED TO REDUCING TURNAROUND TIMES AND HANDLING OF FORMER SET PROCEDURES WITHIN OUR BUSINESS UNITS TO IMPROVE EXISTING CROSS FUNCTION WORKFLOWS. TRAINED NEW EMPLOYEES, PROVIDED FEEDBACK ON THEIR CLAIM DECISIONS TO REDUCE ERRORS AND IMPROVE ON THE CLAIM PROCESS AND PERFORMANCE. APPLIED MEDICAL NECESSITY GUIDELINES, DETERMINED COVERAGE, ELIGIBILITY VERIFICATION, IDENTIFIED DISCREPANCIES AND APPLIED ALL COST CONTAINMENT MEASURES WITHIN THE CLAIM ADJUDICATION PROCESS. Michell Lynn Struck 6053 S. Cory Avenue, Cudahy, WI 53110 (414) 489-9042 mnstruck@att.net Accomplishments and Career Highlights CREATED A PROPOSAL AND PRESENTED IT TO OUR HUMAN RESOURCES DEPARTMENT SHOWING COST SAVINGS AND OTHER POSITIVE IMPACTS HAVING EMPLOYEES OF ALL LEVELS AND IN MULTIPLE DEPARTMENTS WORK AT HOME FULL TIME. THIS CONTRIBUTED TO THE SUCCESSFUL IMPLEMENTATION OF THIS PROGRAM. MAINTAINED 98-100% MONTHLY QUALITY AUDIT RESULTS BY OUR AUDITING DEPARTMENT WITH THE LAST 6 YEARS WORKING AT HOME FULL TIME. SUCCESSFUL MEETING WITH OUR CORPORATE EMPLOYEE BENEFIT DEPARTMENT TO INCLUDE FULL COMPANY SPONSORED BENEFITS TO THE DEPENDENT CHILDREN OF EMPLOYEES WHO WERE THEIR LEGAL GUARDIAN. MANAGED AND COORDINATED OUR TIME INSURANCE MATCHING GRANT PROGRAM. THIS INCLUDED BUDGETING, RECORD KEEPING AND BALANCING OF THE FOUNDATION CHECKBOOK. COORDINATED AND FACILITATED MONTHLY MEETINGS WITH SENIOR MANAGEMENT AND EXECUTIVE BOARD MEMBERS. MADE CLAIM DECISIONS OUTSIDE OF THE GENERAL SCOPE OF RESPONSIBILITIES AFTER RESEARCHING MORE COST EFFECTIVE AND BETTER STREAMLINED WORKFLOWS. PRESENTED SOLID RESULTS TO HIGH LEVELS OF VARIOUS DEPARTMENT HEADS WHICH CONTRIBUTED TO REDUCING TURNAROUND TIMES AND HANDLING OF FORMER SET PROCEDURES WITHIN OUR BUSINESS UNITS TO IMPROVE EXISTING CROSS FUNCTION WORKFLOWS. TRAINED NEW EMPLOYEES, PROVIDED FEEDBACK ON THEIR CLAIM DECISIONS TO REDUCE ERRORS AND IMPROVE ON THE CLAIM PROCESS AND PERFORMANCE. APPLIED MEDICAL NECESSITY GUIDELINES, DETERMINED COVERAGE, ELIGIBILITY VERIFICATION, IDENTIFIED DISCREPANCIES AND APPLIED ALL COST CONTAINMENT MEASURES WITHIN THE CLAIM ADJUDICATION PROCESS. Michell Lynn Struck 6053 S. Cory Avenue, Cudahy, WI 53110 (414) 489-9042 mnstruck@att.net Noted below Last two positions held at Assurant Health/Fortis/Time Insurance Company. Coding Review Associate/Physician Audit Examiner REVIEW OF COMPLEX CLAIMS AND PROVIDE CPT CODE REVIEW RECOMMENDATIONS TO PROCESSING STAFF. WORKED INDEPENDENTLY WHILE UTILIZING MULTIPLE APPROACHES FOR THE INTERPRETATION OF OPERATIVE REPORTS AND PROVISIONS OF THE CPT MANUAL.
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