Monal Patel

Background

About Monal Patel

Healthcare professional with 26+ years of knowledge and expertise in Managed Care; Medicare, Medicaid and Commercial Lines of Business, with a concentration in claims, appeals and customer service. Extensive knowledge of ever changing healthcare regulations and compliance requirements teamed with a “think outside the box” attitude, has consistently delivered on process improvement opportunities to gain accuracy, efficiency, internal/external customer satisfaction and cost control. Excellent leadership skills focused on developing individuals while leading department to exceed the set goals. Process Improvement: Suggested and implemented several process improvement projects including correspondence letter project with support from IT and legal departments which increased efficiency by 67% and accuracy by 15%. Communication: Communicated and trained staff and supporting departments regarding changes to Provider Appeals and Mailroom processes and procedures.Strategic Planning: Using Lean Six Sigma methodology re-defined the process, roles and responsibility within department to more closely align job functions resulting in increased efficiency of 30%.Leadership: Experience in leading multiple cross functional production and quality improvement projects. Selected as a mentor coach for the Claims Future Leader program.Relationship/Team Building: Established and maintained strong collaborative relationships with internal departments: Customer Service, Prior Authorization, Information Technology, Business Integration, Provider Relations, and external customers: Physicians, Physicians Groups, Hospitals and Third Party Billing Agencies.