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| | Click here or scroll down to respond to this candidateSamanthaRiebelSt Paul, MNPHONE NUMBER AVAILABLEEMAIL AVAILABLEExperienceSEPTEMBER 2022 CURRENTChange Implementation Consultant/Wells Fargo, Minneapolis, MNApply project management methodology to facilitate complex implementations of accounts receivable softwareManaged data mapping documentation and guidelines to facilitate data integration and ensure accurate data mapping across systemsDevelop and deliver training sessions to educate employees on the implementation of the new software and its featuresCollaborate with key stakeholders to identify and address potential risks and roadblocks in the implementation processCollaborate with cross-functional teams to identify process improvement opportunities and develop solutions to enhance the implementation processProvide ongoing support and guidance to employees during the implementation timelineOwn process improvement projects, continuous updating and maintaining such processesMentor new project managers provide guidance, training, and assisting with problem solving and decision makingOrganizing and managing all customer communications, including meetings, email and phone callsAPRIL 2022 AUGUST 2022Implementation Project Manager/PairSoft, Miami, FLManage end to end, multiple implementation projectsDeliver software and training of clients in expected timeframeHandle all communications with clients, continued managing close relationshipsResearch issues, adapt responses, and resolve any issuesInternal team buildingProven ability to train on multiple different softwares at onceMulti industry knowledge requiredJUNE 2021 - FEBRUARY 2022Implementation Consultant/Project Manager/FieldEdge, Atlanta, GAManaging timelines of project to deliver product on promised timeTraining clients in trades dispatching and financial softwareUtilize TaskRay (Salesforce) to track project statusLearn continual changes/updates in software to bring to clientsRun webinars directing usage of new software within the companyInternal training of accounting software integrations (QuickBooks / Intacct)Become an expert on processes of managing plumbing, HVAC, electrical companiesWrite processes and workflows for clients based on their specific needs. Implement these within the parameters of the softwareNOVEMBER 2019 JUNE 2021Financial Implementation Consulting Analyst/Matrixcare, Bloomington, MNBuild on-going professional relationships with clientsLeading clients in the implementation of EHR system within facilities, financial softwareMaintaining project budget. Maintaining a minimum billing utilization rateShadow implementations, share notes and suggestions with teammates/leadsManaging training/implementation schedules with multiple clientsDevelop plans for additional consulting services/trainingsBe the expert on every aspect of system and available services, certified through senior staffManage any additional projects from team/clients as requestedClaims Management: UB/1500s: Proficient in billing requirements for all payers. Medicare/Medicaid/Commercial/TricareData Reporting: Census, AR, Billing JournalsManage/Adapt Reporting within Power BIJUNE 2017 NOVEMBER 2019Data Reporting Analyst/Peak TPA, Eden Prairie, MN(PROVIDER NETWORK SPECIALIST, ACCOUNTING ANALYST, HEALTH CARE CLAIMS ANALYST)Responsible for CMS Reporting / RAPS ReportingManaging provider preclusion lists for PACE/MLTC/Medicare Advantage ClientsEncounter Data reportingAudit Provider database/payor information.Own provider network database (Adding, managing all providers data).Train Accountant, and additional staff.Process and pay all claims for a third party payer.Lead tax preparation work for TPA team. Including creating, filing 1099 forms.Work directly with assigned Client, handle claims as requested.Determine if claims are eligible for processing, or require additional information.Contact providers to answer questions related to claims status.Write and distribute recoupment letters, related to any overpayment made.Handle refunds from providers.Distribute funds back to clients.Reconcile books (Quickbooks).Manage Client bank accounts.Create invoices and pay bills related. Allocating money to correct vendors.Create reports related to claims, payments, and GL coding.Write procedures related to any/all processes in accounting and claims analyst role.MAY 2006 JUNE 2017Consumer and Provider Liaison SR/Blue Cross Blue Shield of MN, Eagan, MN(HEALTH SUPPORT COORDINATOR, INTERPLAN REP SR., SENIOR RECOVERY SPECIALIST, SENIOR CUSTOMER SERVICE REPRESENTATIVE)Handling of inquiries from members, over the phone and through written correspondence.Assist new Service Representatives in transitioning from training to the service role floor.Recover funds regarding automotive accident medical claimsHigh level, technical claim support between other Blue Cross plans.Claim adjudication and finalization.Training and workflow writing.Front end review of Medical Review claims, assigning and reviewing prior authorizations.Reviewing member and provider appeals and grievances.Making determinations on claims processing, prior authorization eligibility.Phone and written correspondence from escalated members.Handle all lines of business (Commercial/Individual/Medicare/Medicaid) (Self/Fully insured)EducationHigh School Diploma/Lakeville High School, Lakeville, MN |