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Supervisor I PHEAA July Present
York Hospital July July
Management of staff in call center for federal, state, and private educational loans and grants. Extensive productivity and
activity reporting with various computer programs, including Peoplesoft, Hera, and CSM. Investigation and resolution of security
Professional management of all business operations in outpatient and hospital program settings. Financial administration of annual
provider fee schedule review and rate setting per geographical region, annual budgets, accounts payable, accounts receivable and
payroll. Negotiate out of area provider and nonparticipating provider reimbursement. Responsible for monthly, quarterly, and
annual medical loss reconciliation reporting of both insurance and employee assistance products.
Member Services and Claims Coordination
Verify member benefits and eligibility, including monthly membership downloads. Assess members’ needs for referral to
appropriate service providers. Oversight of all claims, including coordinating benefits between medical carriers and third party
administrators, reviewing and assigning procedural and diagnostic coding, and reviewing and resolving appeals of denied services.
Assess strengths, weaknesses, opportunities and threats in the market. Analyze new revenue streams and diversification of current
services while decreasing expenditures.
Recruitment, supervision and training of staff. Completion of annual performance and merit reviews.
Information Systems Management
Oversight of software and hardware, including assessment of need, evaluation, purchase and maintenance of hardware and
software. Administration of database, incorporating standardized and ad hoc data reports.
Quality Control and Regulatory Compliance
Development, creation, implementation and monitoring of auditing process to ensure performance and statutory standards are met.
University of Tampa Everest University, April
MBA Masters in Business Administration
York College of Pennsylvania, June
Bachelor’s Degree, English/Business
Projects and Accomplishments
? Increased productivity by % while decreasing costs by K with creating and implementing new service authorization
for call center.
? Liaison for businesses, providers and members creating plans for employee assistance programming, using per capita and fee
? Instituted claims and payment audits, improving provider and customer satisfaction ratings.
? Established solid, positive, and productive work environment.
? Electronic downloading of membership files, streamlining processing time by %.