Allina - Provider Services Supervisor

Demonstrated experience with Prior Authorization Management.

Demonstrated experience with Insurance Eligibility & Benefits Verification.

Demonstrated experience with Claims Processing.

Demonstrated experience with Coordination of Benefits (COB).

Demonstrated experience with HIPAA Compliance.

Oversee the processing of outpatient and emergency Letters of Authorization (LOA). Verifying eligibility. Evaluating benefits. Assigning accurate ICD-10 and CPT codes for claim approvals

Managed high-volume billing operations. Coordinated prior authorizations. Resolved claim denials. Maintained precise audit trails across enterprise CRM systems including Salesforce, FACETS, and ACETS

Managed voice account administrative support covering billing operations, insurance enrollments, account cancellations, and benefit inquiries.. Delivered prior authorizations for members utilizing appropriate CPT and ICD codes tailored to specific diagnoses and service requests.. Coordinated and scheduled dental and vision appointments for members, escalating unresolved claim denials to specialized departments.. Documented high-volume customer interactions within CRM platforms (Salesforce, FACETS, ACETS) to maintain precise audit trails and facilitate timely follow-ups.. Consistently met and exceeded key performance indicators (KPIs) in call quality, resolution rates, and customer satisfaction metrics.

Screened and interviewed prospective international candidates across skilled trades, including nursing, carpentry, masonry, and plumbing.. Generated sales leads and built a robust candidate pipeline for international manpower placements.. Executed professional outreach campaigns to prospective global clients to match manpower solutions with organizational needs.. Collaborated with cross-functional recruitment and deployment teams to streamline candidate onboarding and visa/legal documentation.

Conducted audits of patient accounts for credit balances and issued accurate refunds to secondary insurance carriers.. Validated primary insurance coverage through Explanation of Benefits (EOBs) and contractual terms to maintain accurate coordination of benefits.. Analyzed and audited UB-04 claim forms to verify billed procedures and ensure overall claim accuracy.. Managed system uploads of critical claim records and UB-04 documentation to support internal audit trails.

Directed billing operations by generating timely Purchase Orders (POs) and Sales Invoices.. Oversaw nationwide logistics and product delivery workflows utilizing third-party logistics services (Lalamove, Grab, Transportify, DHL, J&T Express).. Managed financial administration tasks, including check collections, bank deposits, inventory control, and office procurement.

Maintained database records for vendor contracts and supplier information.. Executed data entry, filing, and processing of standard purchasing documentation.