Paul Triay

Hammond, LA

ad3r5m@r.postjobfree.com 985-***-****

Director, Audit Operations Profile

Accomplished Audit Manager with 10+ years of demonstrated success in leveraging clinical and financial datasets to drive performance of healthcare systems. Detail-oriented professional with a strong track record of instilling leadership through effective training and compliance to regulatory requirements. Resourceful leader known to design and execute best practices for improve recovery operations using subject matter expertise. Excellent interpersonal skills to foster key relationship with key stakeholders, peers, and clients.

Core Competencies

•Audit Operations

•Account Growth

•Quality Improvement

•Cross-functional Collaboration

•Claim Identification & Recovery

•Customer Service

•Oral and Written Communication

•Compliance

•Contract Management

•Educational Initiatives

•Cost Management

•Interpersonal Skills

Professional Experience

HMS Holdings Corporation, Irving, TX

Manager, Credit Balance Services, June 2012 – Present

Oversee team of Provider Service Analysts across assigned region to include nine states: AR, CO, FL, IL, LA, MO, MS, NM and WI. Interface with government clients on a monthly basis to communicate status updates to address over $10.5M in annual recoveries. Spearhead budgeting, forecasting, and recasting activities to achieve client deliverables in collaboration with team of Program and Regional Directors. Hire and train team of data analysts to foster a growth-focused dynamic to drive revenue opportunities.

Recognized for profitability on an annual basis for five consecutive years.

Enabled vertical advancement of direct reports to management positions through mentorship.

Awarded for consistently high Employee Engagement percentages across Credit Balance Audit Team.

NorthOaks Medical Center, Hammond, LA

Hospital Medical Resolution Analyst/Collector, October 2009 – June 2012

Served as lead subject matter expert for billing and claim resolution requirements and regulation. Resolved open and delinquent claims through consistent and appropriate contact with commercial and managed care companies and Medicare/Medicaid agencies. Ensured confidentiality of all patient accounts by following HIPAA guidelines and adherence to CMS and other payer guidelines. Identified and communicated payer trends to management and peers to facilitate reconciliations.

Designated as the Lead Analyst on the team due to excelling in performance metrics.

Developed and implemented system to identify and address pre-certification process for problematic payers.

Achieved favorable outcomes for hospital through routine filing of secondary appeals.

Education

Bachelor’s Degree

Louisiana State University – Baton Rouge, LA

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