Overview:  

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• 20 years' experience successful Patient and Medicare Beneficiary advocacy with federal and commercial carriers.  Collegiate level adjunct instructor: Medical Coding, Auditing, Medical Billing and Practice Management. In addition to an extensive business background, I am a goal-oriented team member skilled at successfully building cohesive relationships at all levels in the areas of the medical community while managing multiple projects, prioritizing deadlines and developing rapport with patients, providers and colleagues alike.
• Advocating for Patients, Medicare Beneficiaries and their representatives to provide information and counseling on commercial health insurance, and Medicare Parts A, B, D, C (Medicare Advantage Plans) and Medigap/Supplemental Plans. Claim disputes: consistently average greater than 87%  successful dispute resolutions within the first 45 days.
• Claim Dispute Specialist: Collaborating with patients and care providers to streamline claims, reduce initial submission rejection from more than 50% to less than 12% in fewer than 12 months. Claim appeal resolutions consistently average greater than 87%  success rate within the first 45 days.
• Hospice Counselor, volunteer.
• Skilled surgical patient navigator, increasing outside company referrals by more than 27% within 12 months.

• Patients as well as Medicare beneficiaries with claims, appeals and informed referrals--consistently averaging greater than 87%  successful dispute resolutions within the first 45 days.

• Establishing liaison networks and foster community awareness of the 'mechanics' of commercial health insurance policies, Medicare programs, regulations and  the availability of state and local informational assistance programs.

• Highly skilled at facilitating and integrating policies and procedures while coordinating multiple objectives for patients, care providers, state officials and healthcare facilities.

 

Education Highlights:  

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• Master of Arts Western New Mexico University, Silver City, New Mexico; Major in Social Work and Psychology, emphasizing Positive, Behavioral, and Interpersonal Psychology, as well as Community Based Social Work. Specialties: team building and developing creative, collaborative solutions that facilitate exceptional community relationships. 
• Bachelor of Science Susquehanna University, Selinsgrove, Pennsylvania; Major in Marketing, Consumer Behavior, Business Management, Minor in Spanish.
• 2017 CPC Certification: American Association of Professional Coders

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LinkedIn Profile:  https://www.linkedin.com/in/melissamjacksonrobatto