Tanya Hultin

Experience

• 

  Noridian Healthcare Solutions, LLC

  Jul 2000 - Mar 2009

  • Maintain an excellent working knowledge of CMS regulations, processing guidelines, and processing systems• Plan, research, write, proofread, and present educational material for provider community• Respond to all educational/escalated inquiries to include referrals from other teams to assist in claim problem resolution and education about the Medicare program• Establish partnerships and facilitate external committee meetings • Participate in and actively support the internal/external committee meetings • Provide timely and quality education to Medicare providers and beneficiaries using innovative and cost effective technology• Ensure quality administration of CMS regulations Show less Customer Service Representative and Team Trainer 2001 – 2005Noridian Healthcare Solutions, LLC, Fargo, ND• Respond to incoming phone reopening from Medicare Providers• Request documentation and forward to Medical Review when appropriate• Process all requests within timeliness standards set by CMS• Possess detailed working knowledge of Medicare regulations and policies, medical terminology, CPT & ICD-9 coding and Medicare bulletins• Train new and existing employees. Responsible for all development and design of team training and any other training processes identified by quality monitoring and reporting• Ensure that quality checks are measuring tasks as described in training documents• Maintain comprehensive knowledge of CMS regulations, including CMS mandates, Change Requests, updates to the IOM to keep training current• Develop and maintain all documentation, training materials, and other reference tools used within the team to train staff• Evaluate the effectiveness of the training processes and documentation Show less

  • Medicare Education Representative

    Sept 2005 - Mar 2009

  • Telephone Reopenings Team Trainer

    Nov 2001 - Sept 2005

  • Claims Adjudicator

    Jul 2000 - Nov 2001
• 

  Blue Cross Blue Shield of North Dakota

  Mar 2009 - Jun 2011

  • Facilitate training courses for employees to ensure a positive experience for new employees, enhance employee productivity and retention• Develop new training courses and customize existing training courses to meet the needs of management and employees• Provide software support and coaching• Prepare for effective course delivery and ensure accurate training records• Assist employees with practical application of software functions to complete projects efficiently and improve productivity • Contribute to a positive, team-based environment Show less

  • HRIS Specialist

    Jan 2011 - Jun 2011

  • Talent Acquisition Coordinator

    May 2010 - Jan 2011

  • Corporate Technical Trainer

    Mar 2009 - May 2010
• 

  Noridian Healthcare Solutions, LLC

  May 2011 - Jul 2018

  • Effectively communicate and monitor staff based on their job expectations and company values and behaviors • Meet with employees monthly to review monitored expectations• Coach staff and create performance based plans of action when necessary • Monitor team standards and CMS metrics to ensure goals and standards are met• Conduct all aspects of hiring and maintaining staffing levels • Serve as a contact to CMS and other external contacts on Medicare operations • Actively seek ways to improve team processes and create efficiencies within the team and with working with other teams• Motivate and empower staff to be involved in all team processes and goals• Encourage staff to come up with and participate in effective team processes and efficiencies• Demonstrate leadership competency skills and Noridian Values and Behaviors Show less • Research and respond to Congressional and high priority inquiries regarding problems, issues or questions that have not been resolved through normal channels• Maintain working knowledge of CMS regulations, Public Law, Medicare Part A and B guidelines and claims processing requirements• Support all Congressional district offices under NHS jurisdiction, CMS offices, SSA, Medicaid, QIO, and Senior Health Insurance Programs• Support public government relations departments• Possess a clear understanding of entire processing environment, both general contractor responsibilities and other contractors• Work with staff to create Information Warehouse documents for posting to the portal• Finalize the POE Referral Form project in OnBase and aide in company rollout• Website redesign• Respond to provider correspondence within a timely and accurate manner• Complete daily reconciliation of inventory• Ensure monthly reporting is balance and completed timely Show less

  • Operational Team Leader

    Jun 2013 - Jul 2018

  • Government Relations Coordinator

    May 2011 - Jun 2013
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  Blue Cross Blue Shield of North Dakota

  Jul 2018 - now

  • Manager of Payment Integrity

    Jan 2022 - now

  • Manager of Provider Operations

    Aug 2020 - Jan 2022

  • Appeals Manager

    Jul 2018 - Aug 2020