Ava Werstlein

Experience

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  Outreach Healthcare Services

  Jan 2002 - Jan 2003

  Sales Representative

  Responsible for marketing Cardiopulmonary stress testing equipment and services to Physician Practices and Hospital Outpatient DepartmentsIncreased sales and market share by 100% in first six months.Sales growth of 2-5% each month following.Developed Marketing materials for physicians and patients.

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  Lash Group Healthcare Consultants

  Jan 2003 - Jan 2006

  Program Manager

  Managed a specialty team of Reimbursement Consultants responsible for providing national support to Healthcare providers, advocates, and patients. Client base of multiple global Pharmaceutical and Medical Device Manufactures.Expertise in reimbursement policy and guidelines for Pharmaceuticals and Medical Devices.Managed Medicare Part D Education training team supporting the transition of 40,000+ patients from manufacturer based Patient Assistance Programs as well as providing Low Income Subsidy screening/application assistance and enrollment in Prescription Drug Program.Surveillance of Medicare, Medicaid, and Private Payers to monitor national policy and coverage trends in order to provide interpretation and education for clients.Perform on-site educational training for Hospital Directors, Physicians, and Case Managers for reimbursement issues specific to disease states: Advanced Wound Care, Orthopedics, HIV/ AIDS, Schizophrenia, Congestive Heart Failure, Age Related Macular Degeneration, Psoriasis, Women's Health and Urology.Responsible for creating curriculum and training programs for on going team education.Manage Financial forecasting and budgeting for 7 individual clientsCreate and support client reporting and data sharing through weekly, monthly and quarterly reporting. Create educational materials for Pharmaceutical firms targeted to increase product acceptance in the marketplace as well as to strengthen patient understanding of medications.Multiple performance based promotions during tenure with company. Show less

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  Diversified Clinical Services

  Jan 2006 - Jan 2009

  Reimbursement Specialist

  Provide onsite educational training to hospital based DCS managed Wound Care and Hyperbaric Oxygen Treatment Centers throughout the US; visits include review of current program activity, billing/receivables, implementation of DCS reimbursement tools, and support on any ongoing issues with denials, appeals and collectionsProvide detailed reports to Hospital administrations post visit that are used for financial forecasting, program growth and developmentPerform Quarterly financial audits to look for compliance with CMS Policy; Audits also track collections, contractual allowances, and appropriate billing practicesMonitor National and Local policies related to Wound Care and Hyperbaric Oxygen Treatment for DCS policy development; Develop and Manage department tool for tracking updates nation wideCreate educational documents to support services provided at DCS centers; examples include guidance on suggested billing for Pharmaceutical Products, use of Modifiers related to surgical procedures, changes/clarification in NCD and LCD policy, and interpretation of OIG related focus initiatives.Conduct Corporate Training for new hospital Program Directors and Clinical CoordinatorsHome based office; Extensive travel approximately 90% Show less

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  Accelecare Wound Centers, Inc

  Jan 2009 - Aug 2013

  Director of Reimbursement

  Responsible for development and implementation of corporate guidelines related to all aspects of Coding, Billing, and Documentation Compliance for services provided in the Hospital based Outpatient Department. Supported company growth from 16 to 70+ contracts during tenure though development of training efficiencies.Responsible for managing new contract implementation of the revenue cycle process; includes all aspects of the revenue stream while ensuring compliance with local and federal policy.Support development of EMR (Electronic Medical Record) system; hospital outpatient, Skilled Nursing Facility, and hospital inpatient specific considerations.Develop and Maintain Web Based Corporate Training Curriculum for all members of the center personnel including Physicians, Nurses, and non clinical operations staff.Develop and support center auditing program including tool creation, staff training, and resolution strategies for issues identified.Conduct Corporate Training for Clinical and Operations staff Home based office; travel approximately 30% Show less

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  MiMedx Group

  Aug 2013 - Mar 2016

  Senior Manager, Health Policy

  Support the expansion of coverage for medical product (buy and bill) within the Medicare, Medicaid, and Commercial health care payor market. Responsible for the creation of strategic plan to expand coverage in assigned geography. Comprehensive knowledge of payor issues and the ability to articulate shared goals. Create written submissions requesting coverage, discussion of clinical trial data, and how my product can bring shared success to payors, providers and patients.Interact with Medicare, Medicaid, and Commercial Payers on policy development and revision. Show less

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  Medtronic

  Mar 2016 - now

  Supporting all aspects of health policy, reimbursement, and field education for extensive product portfolio.• People Leader for team supporting customer educational programs • Health Policy and Access Expansion through data and analytics to develop market access strategies. • Coding Expertise to support new product code applications leading to code assignment.• Implement creative solutions for increased efficiency and clarity of coverage landscape to support sales objectives• Develop educational tools utilizing various platforms including Salesfoce.com to optimize accesses by removing real and perceived coding, coverage, and reimbursement barriers.• Cross functional team member working with colleagues across the organization for new product launch and portfolio pipeline. • Special projects include working with CMS on code valuation and assignment, value-based healthcare initiative related to payer engagement, coding assessments for products during due diligence, and supporting the development of economic models for assessing best market pathway. • Sales support to align payer strategy with regional and national goals. Show less

  • Director, Health Economics, Policy, and Reimbursement

    Feb 2025 - now

  • Senior Manager, Payer Solutions and Reimbursement

    Mar 2016 - now