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Janet Bogdanski
1513 Homestead PL
Garland, TX 75044
Cell: 214-356-1228
Skills:
• MS word
• MS excel
• Outlook
• Customer Service
PROFESSIONAL EXPERIENCE:
04/13 – 11/15-Insurance Overload Services, LLC
VMS Specialist
• Responsible for Virtual Managed Systems clients, contracts, compliance.
• Received work orders and job description from client portals.
• Perform as Liaison between Branch office and MSP/Hiring Manager
• Manage portal for submittals, candidate status, interviews, hiring/start
information
• Submit candidates into the portal when required based on specific client
requirements.
• Order background screening, drug screening employment verifications, I-9
• Managed end assignment information and ensure all notifications have been sent
and confirmed with necessary parties.
• Maintained compliance paperwork and documentation.
• Maintained contracts documentation and updates.
• Answered phones and directed to the appropriate recruiters.
• parsing resumes
03/10- Present - AT&T Dallas Performance Art Center
Patron Service Rep – Part-time position
• Greet Patrons as they enter venue
• Scan Patrons tickets as they enter theater
• Concierge for taxis, restaurants, art district activities
• Assist ADA patrons depending on their needs
• Handle patron issues both positive and negative
• Trained volunteer ushers
• Answer patron questions and give directions
• Trained in crowd control management for emergencies
6/11 - 04/13 -HDI, Dallas TX
Claims Admin II
• Triage and assign referrals from the UR intake queue
• Data collection, tracking and maintaining accurate UR Assignments for data and
reporting with routine distribution to management
• Assign all referrals within 2 hours of receipt
• High quality of accuracy in assigning incoming UR referrals for accurate
assignment to correct UR staff members insuring compliance with designated
states or referral type
05/10 – 6/11 - Staffing Agency – HDI
Claims Admin - (Completed and assignment at HDI as a Claims Assistant)
• Provides claims support to the Utilization Review Department. Duties include
triaging incoming medical provider calls to determine if UR is required, data
entry, UR Nurse assignment and letter generation. Fast-paced, volume driven
environment.
02/10 – 04/10 - looking for employment
01/10 – 02/10 Staffing Agency - E-surance
Claims Assistant (Completed and assignment at HDI as a Claims Assistant )
• Answer phones and direct caller to appropriate adjustor. Upload faxes to correct
files. Open mail and scanned for processing. Processed checks for outgoing
mail. Handled outgoing mail. Filled in for someone on medical leave.
11/09 – 12/09 - looking for employment
09/09 – 11/09 Staffing Agency -United Healthcare
Customer Service Representative (Completed and assignment Customer Svc Rep)
• Position consisted of handling and recording regular and return mail, utilizing the
database by looking at old data, updating new data in SharePoint, and online
database research. Called providers and hospitals to verify mailing information.
5/09 – 8/09 Qmedtrix - Portland, OR
Medical Fee Negotiator
• Review and perform a preliminary desk audit of medical bills for Workers’
Compensation, Auto and Group clients including inpatient hospital, outpatient
hospital, ambulatory surgery center, DME and professional, ambulance and
home health bills.
• Initiate telephone calls with providers on a national basis to negotiate a
reasonable and customary value for services provided.
• Review and recommend customary values utilizing proprietary bill check
software, nationally published payment data, and Medicare payment regulations.
• Prepare legal papers and correspondence such as proposals and settlement
agreements effectively using company provided computer, software, calculator
and other company provided technology
7/04 – 4/09 Intracorp - Carrollton, TX
Provider Contracting Sr. Associate
• Prepare, analyze, review, and project financial impact of larger/complex provider
contracts and alternate contract terms
• Conduct negotiations and draft individual contracts
• Ensure the smooth operation and administration of provider agreements
• Track financial performance of contracts and ensures compliance within
contracting guidelines
• Provide guidance to less experienced specialists
• Possess strong financial, medical, economic and network management skills
• Possess strong written and verbal communication skills
• Possess good analytical, problem-solving, decision-making and negotiating skills
EDUCATION:
West Leyden Highschool
Richland College, Dallas, TX
El Centro College, Dallas, TX

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Janet Bogdanski Resume - Over 15 Years Claims and Customer Service Experience

  • 1. Janet Bogdanski 1513 Homestead PL Garland, TX 75044 Cell: 214-356-1228 Skills: • MS word • MS excel • Outlook • Customer Service PROFESSIONAL EXPERIENCE: 04/13 – 11/15-Insurance Overload Services, LLC VMS Specialist • Responsible for Virtual Managed Systems clients, contracts, compliance. • Received work orders and job description from client portals. • Perform as Liaison between Branch office and MSP/Hiring Manager • Manage portal for submittals, candidate status, interviews, hiring/start information • Submit candidates into the portal when required based on specific client requirements. • Order background screening, drug screening employment verifications, I-9 • Managed end assignment information and ensure all notifications have been sent and confirmed with necessary parties. • Maintained compliance paperwork and documentation. • Maintained contracts documentation and updates. • Answered phones and directed to the appropriate recruiters. • parsing resumes 03/10- Present - AT&T Dallas Performance Art Center Patron Service Rep – Part-time position • Greet Patrons as they enter venue • Scan Patrons tickets as they enter theater • Concierge for taxis, restaurants, art district activities • Assist ADA patrons depending on their needs • Handle patron issues both positive and negative • Trained volunteer ushers • Answer patron questions and give directions • Trained in crowd control management for emergencies
  • 2. 6/11 - 04/13 -HDI, Dallas TX Claims Admin II • Triage and assign referrals from the UR intake queue • Data collection, tracking and maintaining accurate UR Assignments for data and reporting with routine distribution to management • Assign all referrals within 2 hours of receipt • High quality of accuracy in assigning incoming UR referrals for accurate assignment to correct UR staff members insuring compliance with designated states or referral type 05/10 – 6/11 - Staffing Agency – HDI Claims Admin - (Completed and assignment at HDI as a Claims Assistant) • Provides claims support to the Utilization Review Department. Duties include triaging incoming medical provider calls to determine if UR is required, data entry, UR Nurse assignment and letter generation. Fast-paced, volume driven environment. 02/10 – 04/10 - looking for employment 01/10 – 02/10 Staffing Agency - E-surance Claims Assistant (Completed and assignment at HDI as a Claims Assistant ) • Answer phones and direct caller to appropriate adjustor. Upload faxes to correct files. Open mail and scanned for processing. Processed checks for outgoing mail. Handled outgoing mail. Filled in for someone on medical leave. 11/09 – 12/09 - looking for employment 09/09 – 11/09 Staffing Agency -United Healthcare Customer Service Representative (Completed and assignment Customer Svc Rep) • Position consisted of handling and recording regular and return mail, utilizing the database by looking at old data, updating new data in SharePoint, and online database research. Called providers and hospitals to verify mailing information.
  • 3. 5/09 – 8/09 Qmedtrix - Portland, OR Medical Fee Negotiator • Review and perform a preliminary desk audit of medical bills for Workers’ Compensation, Auto and Group clients including inpatient hospital, outpatient hospital, ambulatory surgery center, DME and professional, ambulance and home health bills. • Initiate telephone calls with providers on a national basis to negotiate a reasonable and customary value for services provided. • Review and recommend customary values utilizing proprietary bill check software, nationally published payment data, and Medicare payment regulations. • Prepare legal papers and correspondence such as proposals and settlement agreements effectively using company provided computer, software, calculator and other company provided technology 7/04 – 4/09 Intracorp - Carrollton, TX Provider Contracting Sr. Associate • Prepare, analyze, review, and project financial impact of larger/complex provider contracts and alternate contract terms • Conduct negotiations and draft individual contracts • Ensure the smooth operation and administration of provider agreements • Track financial performance of contracts and ensures compliance within contracting guidelines • Provide guidance to less experienced specialists • Possess strong financial, medical, economic and network management skills • Possess strong written and verbal communication skills • Possess good analytical, problem-solving, decision-making and negotiating skills EDUCATION: West Leyden Highschool Richland College, Dallas, TX El Centro College, Dallas, TX