Matthew Warner

Experience

• 

  Senator Robert Casey’s office

  Feb 2011 - May 2011

  Intern

  Delivered accurate political information to the Senator’s constituents concerning his views on current issues associated with his political agenda. • Convinced undecided constituents that Senator Casey had their best interest in mind involving controversial issues by thoroughly communicating data that clearly demonstrated the Senator’s views and providing Voters with the information they needed to make informed decisions.• Demonstrated communication, leadership, and problem solving skills to complete tasks in a challenging political office setting to achieve difficult goals and objectives, including completing time sensitive assignments, enhancing and developing a good and meaningful work ethic, and developing skills associated with effective leadership. Show less

• 

  TMG Health

  Nov 2011 - Oct 2012

  Performed over 150 quality reviews monthly and supported all activities pertaining to Medicare and Medicaid guidance and all regulations affecting programs that had a direct impact on Appeals and Grievances for Customer and Ancillary Services.• Developed end-to-end quality process for all clients handled by customer service grievances. Increased the accuracy of which grievances were documented in order to better serve our customers.• Trained and coached all Grievance Coordinators to ensure compliance and efficiency throughout the appeal and grievance processes.• Continuously monitored and interpreted the Centers for Medicare & Medicaid Services Guidance to determine the impact to Appeals and Grievance handling throughout Customer and Ancillary Services. Ensured all current and future grievance procedures stayed in compliance with all Medicare guidelines.• Ensured 100% compliance with all government regulations to minimize organizational risk and maintain good contractual standing with government entities.• Proactively and efficiently resolved, tracked and analyzed approx. 50 issues per week in adherence with policies. Show less Successfully responded to approx. 30 inquiries weekly involving Medicare Part C and Part D plans including receiving, researching and documenting member and provider inquiries and member grievances, and receiving and making outbound calls to members. • Headed off potential problems by thoroughly educating clients about their Medicare Plans including uncertainties regarding what is/is not covered, reducing grievances that would have created more work for the company, and situations that could potentially jeopardize the company’s contract.• Proactively stayed current on all Medicare updates, changes and rulings to be able to provide the highest level of customer service to members.• Exhausted all steps to provide the highest quality service and de-escalate member complaints by providing them with the proper information and alternatives to medical products/services that were not covered. Reduced overhead costs by preventing unnecessary grievances. Show less

  • Senior Quality Specialist

    Mar 2012 - Oct 2012

  • Customer Service Representative

    Nov 2011 - Mar 2012
• 

  Cigna Global Health Benefits

  Nov 2012 - Sept 2013

  Billing & Account Service Associate

  Effectively manage all tasks related to cash application, collection processes, and operating procedures accurately and efficiently. Build strong relationships with customers, colleagues and partners. Managed a multi-million dollar assigned book of business of client accounts.• Resolved over a $1 million in outstanding balances that were past due, ensuring that company met or exceeded their monthly and quarterly financial goals.• Proactively researched current best practices and created and implemented new department operational procedures that aligned with compliance laws, increasing overall efficiency of the team, client retention, and higher customer satisfaction scores. • Known for succeeding in collecting problematic balances that other analysts could not by establishing rapport with clients, building trust and providing detailed documentation to ensure customers understood the process and outcomes.• Facilitated the resolution of complex billing issues by making quality decisions and building lasting professional relationships with clients.• Research, create and utilize various reports including daily wire reports and pay history reports to gauge department metrics and make strategic business decisions to ensure all monies received are allocated correctly to client accounts. Show less

• 

  Cigna

  Jan 2013 - Jan 2014

  Underwriting Senior Associate

  Responsible for determining the premium rate level and plan design structure for individual cases while working in a consultative manner with sales partners to grow Cigna’s book of business.• Individually underwrote disability, life and accident products that have led to the sale of over $150,000 in premium.• Underwrites for companies in CGI’s Emerging Market Segment with complex plan structures, balancing various degrees of risk with sales objectives; contributing to a 10% increase in volume of sales.• Underwrites in excess of 50 cases per month to ensure the company meets and maintains its annual sales goals.• Known for excelling in a fast-paced work environment and is responsible for handling numerous tasks at any given time.• Accepted into Cigna Group Insurance’s ULTRA Underwriting Training Program that is known for being one most rigorous Underwriting programs in the industry. Show less

• 

  TMG Health

  Jan 2016 - Jan 2018

  ITS Claims Processor

  Responsible for creating manual DFs to meet or exceed monthly production goals while ensuring CMS guidelines are followed and quality is maintained.• Consistently met and maintained monthly production goals.• Maintained 100% QC score while increasing monthly production. • Ensured claims are processed correctly and meet all government regulations to minimize organizational risk and maintain good contractual standing with government entities.• Resolved numerous processing errors by following the proper adjustment procedures, in order to ensure claims are paid correctly and in a timely manner.• Continuously provided ideas and solutions in order to improve department goals and production. Show less

• 

  TMG Health

  Feb 2018 - Sept 2019

  Compliance Analyst

  Responsible for reviewing and interpreting regulations for both state and federal government health programs. Facilitate and support clients during regulatory audits. Develop, implement and execute risk assessments and internal monitoring programs.• Individually facilitated the oversight and accurate completion of CMS program audit universes.• Investigated potential compliance issues and facilitated the development of corrective action plans to mitigate potential civil monetary penalties and/or sanctions.• Individually responsible for routinely monitoring and developing monitoring programs to remediate compliance violations.• Serves as a subject matter expert for all of TMG Health’s clients. Show less

• 

  BAKER TILLY VANTAGEN

  Sept 2019 - Aug 2022

  Sr. Account Specialist

  Responsible for managing a multi-million dollar book of business to ensure our FSA, HSA, and HRA clients are receiving the highest level of service. Develop, lead, and coach a small team ensuring that they are meeting the companies goals and expectations.• Individually facilitates high level client complaints, find/create solutions to complex issues, and built a strong client rapport for long lasting business relationships• Excels in a fast paced, every changing business environment by developing and adapting end to end policies and procedures Show less

• 

  Baker Tilly US

  Jul 2022 - now

  • Manager, COBRA

    Aug 2023 - now

  • Account Services Supervisor

    Jul 2022 - Aug 2023