Medical Management
Resume:
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TA R A K N U T S O N
WORK OF EXPERIENCE
Special Investigator
Investigate members, providers and pharmacies for fraud, waste and abuse of health
care
Review medical records
Process claims in multiple systems
Present case history and status to management
Interview members regarding claims and providers
Conduct meetings with management, providers, market office and legal department
to determine outcome of investigation
Analyze data for trend
Billing Specialist Supervisor
Hired and assisted with training personnel
Managed accounts receivable
Accountable for monthly AR of $2 million
Completed end of month collection calls
Supervised team of ten employees
Assisted with escalated client concerns
7/2000 11/20005 Brown County Human Services
Economic Support Specialist
Determined eligibility for food stamps, medical assistance, and childcare assistance
Determined state program overpayments
Interviewed clients in person and over the phone
Processed mail in applications
EDUCATION
1996 University of Washington
BA in Psychology and Sociology
SKILLS
Word, Lotus Notes, Excel, Access, Outlook, Power point
REFERENCES
Available upon request
Contact this candidate