Years of experience: 21
ConsultingMedicalRisk Adjustment CoderBusiness AnalystAdvisorEngagement Manager
Trust Score
Exceptionally trusted; proven professional excellence.
Krista's Career Path
Jul. 2018 -Oct. 2024
Berkeley Research Group LLCSenior Managing Consultant
Tampa/St. Petersburg, Florida AreaLed In-Network and Out-of-Network claim disputes, conducting claim adjudication reviews on cases with over 1,700 sample claims with alleged damages ranging from $10 million to $60 million. Managed teams of up to (10) direct reports, interacting with clients and legal counsel on more than (100) cases, and co-led or led over (50) different matters. Co-directed over (20) coding validation review...
Aug. 2012 -Jul. 2018
Berkeley Research Group LLCConsultant
Tampa/St. Petersburg, Florida Area
Jun. 2011 -Aug. 2012
OptumInsightSenior Business Analyst
Tampa, FLSupported development of new edits, designed to stop suspect claims for investigation before they were paid. Identified potential fraud schemes, analyzed claims data to identify volume of claims and potential savings. Created automated reports to track the number of claims and dollars flagged by models and modules throughout the claim systems. Performed ad-hoc analysis for various departments...