Norma Lindbloom

Experience

• 

  Envolve Vision, Inc.

  Oct 1997 - Oct 2011

  Claim System Analyst

  Claim System Analyst 2010-2011• Developed, programmed, and tested benefit design for new plan implementations and existing plans into the claim system to ensure efficiency and accuracy of payment.• Ensured all associated reference files were current: Local Carrier Determination (LCD), Correct Coding Initiatives (CCI), ICD9-CM, CPT, and HCPC according to Medicaid, Medicare, Foster Care, and Commercial plans• Performed data extracts and create basic reports• Transfer files using secured FTP• Research data integrity issues and provide suggestions on improvement• Perform basic testing to validate systems configuration changes• Developed solutions for manual workarounds in the adjudication process• Resolve basic and complex claims payment discrepancies against contractual fee schedules, state, and federal guidelines, and health plan contractual guidelines• Strong knowledge of Resource-Based Relative Value System (RBRVS)Customer Relations Manager, 2008-2010• Managed a staff of 16 and all functions of the Customer Relations Department (Call Center) including hiring, staff development, and training, policies, and procedures, implement service level agreements to meet customer benchmarks for abandoned calls, delay to answer, calls answered within 30 seconds, and average hold time• Managed operational aspects of the telephone system including plan reporting, agent performance, messaging, line closings, inclement weather set-ups• Performed call monitoring and auditing.Claims Supervisor, 2001 – 2008• Managed a staff of 12 and all functions of the Claims Processing Department including Claim Control, OCR Imaging, IKE/VAL process, Claim Adjudication, Claim Reporting, and Claim Auditing.Director of Georgia Eye Care, 1997-2001• Managed a TPA contract of Claims Processing through closing to be submitted to the TPA each closeout for provider reimbursement. Show less

• 

  Edgepark

  Jan 2012 - Jul 2014

  Medical Denial Analyst

  • Research and analyze denials. Identify trends with reimbursement and coding. Provide information, feedback, and direction on coding-related denial issues, reimbursement trends, and billing/coding errors. • Denials include Medicare/ Medicaid and Commercial reimbursement. Primary and secondary medical denials• Follow state and federal laws, rules, and regulations regarding reimbursement.• Update accounts receivable in patients' accounts according to the denial to produce accurate billing statements.• Notify patients of the denial of any patient responsibility. Show less

• 

  Qualis - Intelligent DME Solutions

  Jul 2014 - Oct 2024

  • Manage staff with all functions of the census loading, manual and electronic invoice processing, vendor reimbursement, client billing for Hospice (DME), and system user access.• Set up new accounts in the company’s software application.• Maintain adequate staff through talent acquisition, onboarding, new hire training, and offboarding.• Review and place software upgrade requests to ensure a smooth end-user experience.• Assist IT with testing software tickets to ensure correct functionality.• Review all departmental standard policies and procedures (SOP’s) to ensure they are updated yearly.• Continue Process Improvement within Qualis• Strategic Planning• Technical Innovation in resolving workflow issues.• Customer Service • Assist in system upgrades• Member of the Operations Team Show less • Manage staff of 11 with all functions of the online order entry process for Durable Medical Equipment (DME), provider reimbursement, and client billing for Hospice (DME). • Maintain adequate staff through talent acquisition, onboarding, new hire training, and offboarding. • Review and place software upgrade requests to ensure a smooth end-user experience.• Assist IT with testing software tickets to ensure correct functionality.• Accomplished a reduction of manual intervention for the online order review process which eliminated the need for an additional FTE. • Developed an automated process for adjustment to reduce cost.• Ensured staff safety by creating and implementing work-at-home policies and office safety protocols during the COVID-19 pandemic.• Reviewed all standard policies and procedures to ensure they are updated yearly.• Manage phone loops to optimize the caller experience through Digium Switchvox• Tested new softphone capability of the upgraded phone system. • Volunteer for rotation to assist with Quality Improvement requests over the weekends. • Train staff on HIPAA guidelines. • Train staff on the MAGIC principle of customer service. Show less

  • VP, System Services

    Aug 2021 - Oct 2024

  • VP of POD Administration

    Feb 2016 - Aug 2021

  • POD Team Manager

    Jul 2014 - Feb 2016
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  KINEXO

  Oct 2024 - now

  National Account Manager