Speakers | Kisaco Research

Speakers

3rd Annual Healthcare Payment & Revenue Integrity Congress South | February 2025
February 2025
Miami
  • Author:

    Dr Priscilla Alfaro, MD, FAAP, CPC, CPMA, COC, CIC, CFE

    VP Payment Integrity
    Blue Cross NC

    Dr Priscilla Alfaro, MD, FAAP, CPC, CPMA, COC, CIC, CFE

    VP Payment Integrity
    Blue Cross NC
  • Author:

    David Flannery

    Director of Telegenetics and Digital Genetics
    Cleveland Clinic

    David Flannery is a "pioneer" in telemedicine, having started telegenetics clinic in 1995 in Georgia. He’s currently the Director of Telegenetics and Digital Genetics at Cleveland Clinic. He has expertise with ICD-10 coding and CPT codes. He oversaw the revenue cycle management for the 300+ physician practice group at the Medical College of Georgia. He served on the American Medical Association's Digital Medicine Payment Advisory Group, developing new CPT codes for telemedicine and digital medicine.

    David Flannery

    Director of Telegenetics and Digital Genetics
    Cleveland Clinic

    David Flannery is a "pioneer" in telemedicine, having started telegenetics clinic in 1995 in Georgia. He’s currently the Director of Telegenetics and Digital Genetics at Cleveland Clinic. He has expertise with ICD-10 coding and CPT codes. He oversaw the revenue cycle management for the 300+ physician practice group at the Medical College of Georgia. He served on the American Medical Association's Digital Medicine Payment Advisory Group, developing new CPT codes for telemedicine and digital medicine.

  • Author:

    Dr. Ahmad Kilani MD, MBA, MLS, MSIT, CHCQM-PHYADV, FACP, FACHE

    Medical Director
    Cleveland Clinic

    Dr. Ahmad Kilani MD, MBA, MLS, MSIT, CHCQM-PHYADV, FACP, FACHE

    Medical Director
    Cleveland Clinic
  • Author:

    Anthony Baize

    Inspector General
    Wisconsin Department of Health Services

    Anthony Baize has been the Inspector General for the Wisconsin Department of Health Services since 2016.  He holds a master's degree in public administration from Indiana State University and a Certified Inspector General (CIG) credential from the Association of Inspectors General.  Prior to joining Wisconsin state government, Baize was the deputy director of audits and investigations for the Office of the Inspector General for the Kentucky Cabinet of Health and Family Services.

    Anthony Baize

    Inspector General
    Wisconsin Department of Health Services

    Anthony Baize has been the Inspector General for the Wisconsin Department of Health Services since 2016.  He holds a master's degree in public administration from Indiana State University and a Certified Inspector General (CIG) credential from the Association of Inspectors General.  Prior to joining Wisconsin state government, Baize was the deputy director of audits and investigations for the Office of the Inspector General for the Kentucky Cabinet of Health and Family Services.

  • Author:

    Gregory Bryant

    Chief Information Officer
    Gov Juan F. Luis Hospital & Medical Center

    Gregory Bryant

    Chief Information Officer
    Gov Juan F. Luis Hospital & Medical Center
  • Author:

    Richelle Marting, JD, MHSA,RHIA,CPC,CEMC,CPMA

    Director of Managed Care
    North Kansas City Hospital

    Richelle Marting, JD, MHSA,RHIA,CPC,CEMC,CPMA

    Director of Managed Care
    North Kansas City Hospital
  • Author:

    Novelette Wallace, MPH, PMP, CSSBB

    Head of Payment Integrity
    Johns Hopkins Healthcare

    Novelette Wallace is a distinguished Payment Integrity Leader with a rich background spanning over 30 years in the healthcare industry. Her extensive experience includes leadership roles within payment integrity, where she has played pivotal roles in both payment integrity vendor organizations and health plans. Throughout her career, Novelette has demonstrated a remarkable ability to build and lead Payment Integrity departments from their inception. Her expertise has been instrumental in establishing robust processes and strategies to identify and recover inaccuracies in claims, contributing significantly to cost of care savings for health plans year after year.

    Novelette has held key leadership positions with industry-leading organizations, including Performant Corp, United Healthcare, and Aetna (previously Coventry). In each role, she has consistently delivered results by optimizing payment integrity processes and driving operational excellence. Currently serving as the Assistant Vice President (AVP) of Payment Integrity for Johns Hopkins Health Plans, Novelette continues to bring her wealth of knowledge and leadership acumen to the forefront. Her dedication to achieving and surpassing cost of care savings goals exemplifies her commitment to advancing the financial health and efficiency of healthcare organizations.

    With a proven track record of success and a comprehensive understanding of payment integrity within the healthcare landscape, Novelette Wallace stands as a respected leader in the industry, contributing significantly to the success of the organizations she serve

    Novelette Wallace, MPH, PMP, CSSBB

    Head of Payment Integrity
    Johns Hopkins Healthcare

    Novelette Wallace is a distinguished Payment Integrity Leader with a rich background spanning over 30 years in the healthcare industry. Her extensive experience includes leadership roles within payment integrity, where she has played pivotal roles in both payment integrity vendor organizations and health plans. Throughout her career, Novelette has demonstrated a remarkable ability to build and lead Payment Integrity departments from their inception. Her expertise has been instrumental in establishing robust processes and strategies to identify and recover inaccuracies in claims, contributing significantly to cost of care savings for health plans year after year.

    Novelette has held key leadership positions with industry-leading organizations, including Performant Corp, United Healthcare, and Aetna (previously Coventry). In each role, she has consistently delivered results by optimizing payment integrity processes and driving operational excellence. Currently serving as the Assistant Vice President (AVP) of Payment Integrity for Johns Hopkins Health Plans, Novelette continues to bring her wealth of knowledge and leadership acumen to the forefront. Her dedication to achieving and surpassing cost of care savings goals exemplifies her commitment to advancing the financial health and efficiency of healthcare organizations.

    With a proven track record of success and a comprehensive understanding of payment integrity within the healthcare landscape, Novelette Wallace stands as a respected leader in the industry, contributing significantly to the success of the organizations she serve

  • Author:

    Dr Deepak Goyal, MD, MBBS, MBA, CPE, CHCQM, CMRP, CMPC

    Executive Medical Director Revenue Cycle and Supply Chain
    Monument Health

    Dr Deepak Goyal, MD, MBBS, MBA, CPE, CHCQM, CMRP, CMPC

    Executive Medical Director Revenue Cycle and Supply Chain
    Monument Health
  • Author:

    Dr Brad Archer

    Chief Medical Officer
    Monument Health

    Dr Brad Archer

    Chief Medical Officer
    Monument Health
  • Author:

    Kelly Bennett, JD, CFE, AHFI

    Medicaid Program Integrity Chief
    Agency for Health Care Administration

    Kelly Bennett, JD, CFE, AHFI

    Medicaid Program Integrity Chief
    Agency for Health Care Administration
  • Author:

    Jenny Raulerson, BSN, MSHI

    Sr Clinical Consultant
    Florida Blue

    Jenny Raulerson, BSN, MSHI

    Sr Clinical Consultant
    Florida Blue
  • Author:

    Kelly Springmann

    Provider Enablement & Product Development
    Florida Blue

    Kelly Springmann

    Provider Enablement & Product Development
    Florida Blue
  • Author:

    Rae A. McIntee, DDS, MD, MBA, FACS, CPE

    Medical Director Payment Integrity and Special Investigations
    Blue Cross and Blue Shield of Louisiana

    Rae A. McIntee, DDS, MD, MBA, FACS, CPE

    Medical Director Payment Integrity and Special Investigations
    Blue Cross and Blue Shield of Louisiana
  • Author:

    Colleen Gianatasio

    Director, Clinical Documentation Integrity and Coding Compliance
    CDPHP

    Colleen is a strategic clinical documentation, coding and compliance, and risk adjustment expert with 10+ years of experience driving increases in provider engagement. She has thoughtfully built clinical documentation improvement programs from scratch to target accurate risk scores, increases in provider satisfaction, and cost-savings.

    Beyond her role at CDPHP, Colleen is also currently the president of the AAPC National Advisory Board.

    Colleen Gianatasio

    Director, Clinical Documentation Integrity and Coding Compliance
    CDPHP

    Colleen is a strategic clinical documentation, coding and compliance, and risk adjustment expert with 10+ years of experience driving increases in provider engagement. She has thoughtfully built clinical documentation improvement programs from scratch to target accurate risk scores, increases in provider satisfaction, and cost-savings.

    Beyond her role at CDPHP, Colleen is also currently the president of the AAPC National Advisory Board.

  • Author:

    Monique Pierce

    Head of Payment Integrity
    Devoted Health

    Monique is a Strategic Executive Healthcare Leader with proven ability to develop solutions and maximize the benefits of Payment Integrity programs.  She is known for having excellent domain knowledge and being driven, high performing, and having a deep dedication to recruiting and developing top talent.

     

    Monique started her Payment Integrity career at Oxford HealthPlans in the COB and Subrogation Department after spending time in Payment Policy.  When United Healthcare acquired many health plans in the early 2000s like Oxford, Monique was tagged as part of the Optum team to integrate the processes and people into the COB systems that she had built at Oxford.  She led systems development, quality, reporting, operations, vendor management and was responsible for creating innovative proactive programs that more than doubled savings to $1.4B in three years.

     

    Monique developed a successful program that reduced interest expense on late claims for UHC, assisted a communication company to develop COB tools and assisted in strategic system projects before joining SCIO Health Analytics in 2014 to develop new products - specifically prepayment programs.

    In 2015 she became the product owner of SCIOMine, the company’s internal audit application and managed the roadmap.  Monique also owned

    strategic direction for operational metrics and reporting including executive scorecards. Monique was promoted to VP of Business Opportunities and Client Engagement where she improved Audit Recovery TAT by 39% and reduced client implementations TAT by 11% and the Level of Effort by 18% while increasing the count of implementation projects by 126%.

     

    In 2020 Monique joined Devoted Health, a startup company with the goal of building the first ever integrated Payment Integrity Program.  The company has one system, great data, and a great mission; to change health care by treating every member as if they are family.

     

    In her spare time, Monique volunteers her time in the community on the Board of Directors of SCARE NH and works in her family business LARP Portal with her husband Rick.

    Monique Pierce

    Head of Payment Integrity
    Devoted Health

    Monique is a Strategic Executive Healthcare Leader with proven ability to develop solutions and maximize the benefits of Payment Integrity programs.  She is known for having excellent domain knowledge and being driven, high performing, and having a deep dedication to recruiting and developing top talent.

     

    Monique started her Payment Integrity career at Oxford HealthPlans in the COB and Subrogation Department after spending time in Payment Policy.  When United Healthcare acquired many health plans in the early 2000s like Oxford, Monique was tagged as part of the Optum team to integrate the processes and people into the COB systems that she had built at Oxford.  She led systems development, quality, reporting, operations, vendor management and was responsible for creating innovative proactive programs that more than doubled savings to $1.4B in three years.

     

    Monique developed a successful program that reduced interest expense on late claims for UHC, assisted a communication company to develop COB tools and assisted in strategic system projects before joining SCIO Health Analytics in 2014 to develop new products - specifically prepayment programs.

    In 2015 she became the product owner of SCIOMine, the company’s internal audit application and managed the roadmap.  Monique also owned

    strategic direction for operational metrics and reporting including executive scorecards. Monique was promoted to VP of Business Opportunities and Client Engagement where she improved Audit Recovery TAT by 39% and reduced client implementations TAT by 11% and the Level of Effort by 18% while increasing the count of implementation projects by 126%.

     

    In 2020 Monique joined Devoted Health, a startup company with the goal of building the first ever integrated Payment Integrity Program.  The company has one system, great data, and a great mission; to change health care by treating every member as if they are family.

     

    In her spare time, Monique volunteers her time in the community on the Board of Directors of SCARE NH and works in her family business LARP Portal with her husband Rick.

  • Author:

    David Ott

    Director of Consulting Services
    CGI

    David Ott has over 28 years of experience in the healthcare and financial services industries. David has provided leadership and direction to department leaders and teams that support a variety of functions, including business development, payment integrity, claims processing, global project management and quality practices.

    David Ott

    Director of Consulting Services
    CGI

    David Ott has over 28 years of experience in the healthcare and financial services industries. David has provided leadership and direction to department leaders and teams that support a variety of functions, including business development, payment integrity, claims processing, global project management and quality practices.

  • Author:

    Karen Ballard

    Director of Consulting Services
    CGI

    Karen Ballard is Director of Consulting Services, CGI, where she is responsible for managing the CGI ProperPay payment integrity platform. With a nearly 20-year career in the health payer space, Karen possesses a deep knowledge of claims processing, product management, payment integrity, and the Blue payer dynamic. Prior to joining CGI, Karen held a variety of positions in claims operations, BlueCard, and payment integrity during her 17-year tenure with Elevance Health (Anthem).

    Karen holds a Bachelor of Arts and a Master of Business Administration from Southern New Hampshire University. She co-founded and previously co-facilitated the Blue PI Committee, comprised of payment integrity leaders from all 33 Blue Cross and Blue Shield plans and partnered with the Blue Cross and Blue Shield Association to drive change in the payment integrity space.

    Karen Ballard

    Director of Consulting Services
    CGI

    Karen Ballard is Director of Consulting Services, CGI, where she is responsible for managing the CGI ProperPay payment integrity platform. With a nearly 20-year career in the health payer space, Karen possesses a deep knowledge of claims processing, product management, payment integrity, and the Blue payer dynamic. Prior to joining CGI, Karen held a variety of positions in claims operations, BlueCard, and payment integrity during her 17-year tenure with Elevance Health (Anthem).

    Karen holds a Bachelor of Arts and a Master of Business Administration from Southern New Hampshire University. She co-founded and previously co-facilitated the Blue PI Committee, comprised of payment integrity leaders from all 33 Blue Cross and Blue Shield plans and partnered with the Blue Cross and Blue Shield Association to drive change in the payment integrity space.

  • Author:

    Aaron Browder

    President
    Carelon Subrogation

    Aaron Browder is Staff Vice President, Elevance Health and President, Carelon Subrogation, formerly Meridian Resource Company (Meridian), where he and his team are responsible for overseeing the successful implementation and execution of our clients’ end-to-end subrogation programs. With a nearly 20-year career in subrogation, Aaron possesses a deep knowledge of healthcare subrogation. He has held a wide range of management positions throughout his tenure at Meridian, most recently serving as Staff Vice President. Prior to joining Meridian, Aaron gained experience in the financial services and insurance industries with Arthur Andersen, LLP/KPMG, LLP, and Travelers Property Casualty.

    Aaron holds a Bachelor of Arts degree from Indiana University and a Master of Business Administration from Butler University. He served on the Board of Directors for the National Association of Subrogation Professionals and has been a national presenter and author on issues related to subrogation.

     

    Aaron Browder

    President
    Carelon Subrogation

    Aaron Browder is Staff Vice President, Elevance Health and President, Carelon Subrogation, formerly Meridian Resource Company (Meridian), where he and his team are responsible for overseeing the successful implementation and execution of our clients’ end-to-end subrogation programs. With a nearly 20-year career in subrogation, Aaron possesses a deep knowledge of healthcare subrogation. He has held a wide range of management positions throughout his tenure at Meridian, most recently serving as Staff Vice President. Prior to joining Meridian, Aaron gained experience in the financial services and insurance industries with Arthur Andersen, LLP/KPMG, LLP, and Travelers Property Casualty.

    Aaron holds a Bachelor of Arts degree from Indiana University and a Master of Business Administration from Butler University. He served on the Board of Directors for the National Association of Subrogation Professionals and has been a national presenter and author on issues related to subrogation.

     

  • Author:

    Sherri Richardson

    Strategy, Growth and Program Director
    Carelon

    As a strategic leader in Program Integrity Health Insurer industry and having mastered the world of “coordination of benefits”, Sherri is passionate about helping our customers and peers navigate the complex world of healthcare. With a proven track record of success in optimizing program efficiency and minimizing cost of care for Members who are eligible/entitled to two health coverages, Sherri is dedicated to ensuring the industry processes are focused on minimizing members out of pocket and provider/insurers administrative costs.

    Sherri has 30+ years Health Insurer Industry experience. Operational Excellence, mapping program Strategy is Her Leadership background includes leading highly productive operational teams and all functions of COB Operations within the Commercial, Medicare, Affordable Care Act, Medicaid, Subrogation and Senior market.

    As an Elevance/Carelon Corporate Presenter, Sherri enjoys developing training and motivational material, as well as sharing her knowledge and best practices related to maximizing Health Coverage with members, groups, providers and other insurer peers.

    Sherri’s experience in health insurance runs deeps, having the privilege of leadership at Elevance/Carelon for 30+ years, and mentoring from industry leaders. Sherri is a life-long learner and strongly encourages others to learn and grow through continued experiences and educational opportunities.

    On a personal note; As a prior Fitness Trainer, Sherri enjoys Weight Training, Yoga, Aerial Silks, and Master Swimming.  Oftentimes joins the local 5K runs and loves to cook.   

    Sherri Richardson

    Strategy, Growth and Program Director
    Carelon

    As a strategic leader in Program Integrity Health Insurer industry and having mastered the world of “coordination of benefits”, Sherri is passionate about helping our customers and peers navigate the complex world of healthcare. With a proven track record of success in optimizing program efficiency and minimizing cost of care for Members who are eligible/entitled to two health coverages, Sherri is dedicated to ensuring the industry processes are focused on minimizing members out of pocket and provider/insurers administrative costs.

    Sherri has 30+ years Health Insurer Industry experience. Operational Excellence, mapping program Strategy is Her Leadership background includes leading highly productive operational teams and all functions of COB Operations within the Commercial, Medicare, Affordable Care Act, Medicaid, Subrogation and Senior market.

    As an Elevance/Carelon Corporate Presenter, Sherri enjoys developing training and motivational material, as well as sharing her knowledge and best practices related to maximizing Health Coverage with members, groups, providers and other insurer peers.

    Sherri’s experience in health insurance runs deeps, having the privilege of leadership at Elevance/Carelon for 30+ years, and mentoring from industry leaders. Sherri is a life-long learner and strongly encourages others to learn and grow through continued experiences and educational opportunities.

    On a personal note; As a prior Fitness Trainer, Sherri enjoys Weight Training, Yoga, Aerial Silks, and Master Swimming.  Oftentimes joins the local 5K runs and loves to cook.   

  • Author:

    Kyle Pankey

    Sales & Growth Leader
    Carelon Subrogation

    Kyle Pankey has over two decades of experience working within the healthcare and payer operations, with over 10 years specifically tied in to the payment integrity space.   Kyle lives in Chattanooga, TN and has served as Carelon Subrogation’s growth leader since mid-2022.

    Kyle Pankey

    Sales & Growth Leader
    Carelon Subrogation

    Kyle Pankey has over two decades of experience working within the healthcare and payer operations, with over 10 years specifically tied in to the payment integrity space.   Kyle lives in Chattanooga, TN and has served as Carelon Subrogation’s growth leader since mid-2022.

  • Author:

    Dr. Michael Menen

    Chief Medical Officer
    MedReview
    •Former Chief Medical Officer at Optum
    •Bachelor of Science degree in theoretical mathematics from the University of California, Riverside
    •Doctor of Medicine degree from the Medical College of Wisconsin
    •Board-certified invasive cardiologist and a fellow of the American College of Cardiology

    Dr. Michael Menen

    Chief Medical Officer
    MedReview
    •Former Chief Medical Officer at Optum
    •Bachelor of Science degree in theoretical mathematics from the University of California, Riverside
    •Doctor of Medicine degree from the Medical College of Wisconsin
    •Board-certified invasive cardiologist and a fellow of the American College of Cardiology
  • Author:

    Karen Weintraub

    Executive Vice President
    HEALTHCARE FRAUD SHIELD

    With 25 years of data and 20 years of healthcare experience, Ms. Weintraub is currently responsible for the design and development of the company’s healthcare fraud detection software products and services. She provides subject matter expertise on system design and workflow, business rule development, data mining and fraud outlier algorithms as well as SIU policies and procedures. Prior to joining Healthcare Fraud Shield, managed SIUs on various healthcare investigations for all commercial, Medicaid and Medicare business and claims of fraudulent activity. Ms. Weintraub received a BA in Criminal Justice from the University of Delaware and an MA in Criminal Justice from Rutgers University. Ms. Weintraub is a Certified Professional Coder for Payers (CPC-P), a Certified Professional Medical Auditor (CPMA) from the American Academy of Professional Coders, a Certified Dental Coder (CDC) from the American Dental Association, and the founder of the Hamilton, NJ AAPC chapter. She is also an Accredited Healthcare Fraud Investigator (AHFI) from the National Healthcare Anti-Fraud Association (NHCAA). Ms. Weintraub Taught CPT Coding, Fraud & Audits, and Medical Billing, Laws and Ethics and the local community college. 

    Karen Weintraub

    Executive Vice President
    HEALTHCARE FRAUD SHIELD

    With 25 years of data and 20 years of healthcare experience, Ms. Weintraub is currently responsible for the design and development of the company’s healthcare fraud detection software products and services. She provides subject matter expertise on system design and workflow, business rule development, data mining and fraud outlier algorithms as well as SIU policies and procedures. Prior to joining Healthcare Fraud Shield, managed SIUs on various healthcare investigations for all commercial, Medicaid and Medicare business and claims of fraudulent activity. Ms. Weintraub received a BA in Criminal Justice from the University of Delaware and an MA in Criminal Justice from Rutgers University. Ms. Weintraub is a Certified Professional Coder for Payers (CPC-P), a Certified Professional Medical Auditor (CPMA) from the American Academy of Professional Coders, a Certified Dental Coder (CDC) from the American Dental Association, and the founder of the Hamilton, NJ AAPC chapter. She is also an Accredited Healthcare Fraud Investigator (AHFI) from the National Healthcare Anti-Fraud Association (NHCAA). Ms. Weintraub Taught CPT Coding, Fraud & Audits, and Medical Billing, Laws and Ethics and the local community college. 

  • Author:

    Lacey Crowl

    VP of Health Plan Operations
    Longevity Health Plan

    Lacey Crowl is the Director of Claims Operations for Longevity Health Plan, responsible for the accuracy of claims processing focused on Medicare members. Lacey has experience in the Commercial, Medicare and Medicaid environments, developing prospective and retrospective payment integrity solutions for both clinical and claim coding reviews. She has operated within various claims processing platforms to develop, code and implement new audit concepts while operating within the Managed Care space.

    Lacey Crowl

    VP of Health Plan Operations
    Longevity Health Plan

    Lacey Crowl is the Director of Claims Operations for Longevity Health Plan, responsible for the accuracy of claims processing focused on Medicare members. Lacey has experience in the Commercial, Medicare and Medicaid environments, developing prospective and retrospective payment integrity solutions for both clinical and claim coding reviews. She has operated within various claims processing platforms to develop, code and implement new audit concepts while operating within the Managed Care space.

  • Author:

    Matt Ruyter

    Senior Director of Product
    Paradigm

    Matt Ruyter

    Senior Director of Product
    Paradigm
  • Author:

    Mike Spellman

    Senior Director, Consulting & Solution Design
    Lyric

    Mike Spellman

    Senior Director, Consulting & Solution Design
    Lyric
  • Author:

    Toni Case

    Vice President, National Sales
    CERIS

    Toni Case

    Vice President, National Sales
    CERIS
  • Author:

    Lawrence M. Simon, MD, MBA, FACS

    Interim Senior Medical Director
    Blue Cross and Blue Shield of Louisiana (BCBSLA)

    Dr. Larry Simon is the Interim Senior Medical Director and Managing Medical Director for Medical Policy and Medical Appeals for Blue Cross and Blue Shield of Louisiana (BCBSLA), where he also serves as the Medical Director for Coding and Reimbursement and Chair of the Credentialing and Medical Quality Management Committees.  He is a member of the AMA CPT Editorial Panel, serving on the Executive Committee and as Co-Chair of the Molecular Pathology Advisory Group and Genomic Sequencing Procedures Workgroup.  He also chairs the Medical Director’s Forum for both the Louisiana Association of Health Plans and the National Anti-Fraud Advisory Board of the Blue Cross and Blue Shield Association.  Prior to joining BCBSLA, Dr. Simon served in numerous leadership roles for the American Academy of Otolaryngology, the American Medical Association, the American College of Surgeons, and the Louisiana State Medical Society. 

    Dr. Simon is an alumnus of Louisiana State University, Baylor College of Medicine, Rady Children’s Hospital, and the BI Moody College of Business Administration at the University of Louisiana.  A diplomate of the American Board of Otolaryngology and a Fellow of the American College of Surgeons, Dr. Simon has over 15 years of experience in Health Policy and Healthcare Reform, and he has presented over 170 lectures and seminars on these topics. 

    A Rotarian, an animal rescuer, a member of multiple civic boards, and a patron of the arts, Dr. Simon enjoys spending his time outside of work serving his community, helping the animal shelters and abandoned dogs of Louisiana, and travelling and enjoying life with his wife and their family and friends.

    Lawrence M. Simon, MD, MBA, FACS

    Interim Senior Medical Director
    Blue Cross and Blue Shield of Louisiana (BCBSLA)

    Dr. Larry Simon is the Interim Senior Medical Director and Managing Medical Director for Medical Policy and Medical Appeals for Blue Cross and Blue Shield of Louisiana (BCBSLA), where he also serves as the Medical Director for Coding and Reimbursement and Chair of the Credentialing and Medical Quality Management Committees.  He is a member of the AMA CPT Editorial Panel, serving on the Executive Committee and as Co-Chair of the Molecular Pathology Advisory Group and Genomic Sequencing Procedures Workgroup.  He also chairs the Medical Director’s Forum for both the Louisiana Association of Health Plans and the National Anti-Fraud Advisory Board of the Blue Cross and Blue Shield Association.  Prior to joining BCBSLA, Dr. Simon served in numerous leadership roles for the American Academy of Otolaryngology, the American Medical Association, the American College of Surgeons, and the Louisiana State Medical Society. 

    Dr. Simon is an alumnus of Louisiana State University, Baylor College of Medicine, Rady Children’s Hospital, and the BI Moody College of Business Administration at the University of Louisiana.  A diplomate of the American Board of Otolaryngology and a Fellow of the American College of Surgeons, Dr. Simon has over 15 years of experience in Health Policy and Healthcare Reform, and he has presented over 170 lectures and seminars on these topics. 

    A Rotarian, an animal rescuer, a member of multiple civic boards, and a patron of the arts, Dr. Simon enjoys spending his time outside of work serving his community, helping the animal shelters and abandoned dogs of Louisiana, and travelling and enjoying life with his wife and their family and friends.

  • Author:

    Alan Coulter

    VP of Business Development
    Performant

    Alan Coulter

    VP of Business Development
    Performant
  • Author:

    Ray Evans

    Vice President of Healthcare Sales
    CoventBridge Group

    Ray Evans is a dynamic business development executive with extensive experience working within, and servicing healthcare organizations. He holds the position of Vice President of Healthcare Sales at CoventBridge Group where he utilizes his experience to share with the industry CoventBridge’s unmatched FWA investigative solutions. His goal is to work with health plans in protecting their organization from FWA through an experienced, flexible, and sensitive approach to minimizing provider abrasion, while still achieving organizational objectives.

    Ray Evans

    Vice President of Healthcare Sales
    CoventBridge Group

    Ray Evans is a dynamic business development executive with extensive experience working within, and servicing healthcare organizations. He holds the position of Vice President of Healthcare Sales at CoventBridge Group where he utilizes his experience to share with the industry CoventBridge’s unmatched FWA investigative solutions. His goal is to work with health plans in protecting their organization from FWA through an experienced, flexible, and sensitive approach to minimizing provider abrasion, while still achieving organizational objectives.

  • Author:

    Amy Anzola, RN, MSN

    VP, Clinical Operations
    Apixio

    Amy Anzola, RN, MSN

    VP, Clinical Operations
    Apixio
  • Author:

    Brad Ross

    EVP, Payment Integrity
    Apixio

    Brad Ross

    EVP, Payment Integrity
    Apixio
  • Author:

    David V. Cardelle, R.Ph.

    Chief Strategy Officer, SVP, Health Plan Strategy & Partnerships
    Advanced Medical Strategies

    David V. Cardelle, R.Ph.

    Chief Strategy Officer, SVP, Health Plan Strategy & Partnerships
    Advanced Medical Strategies
  • Author:

    John-Michael Loke

    SVP, Health Plan Strategy & Partnerships
    AMS

    John-Michael Loke

    SVP, Health Plan Strategy & Partnerships
    AMS
  • Author:

    Chandra Kuti

    VP, Government Solutions Operations
    CoventBridge Group

    Chandra Kuti

    VP, Government Solutions Operations
    CoventBridge Group
  • Author:

    Ram Davaloor

    Founder and COO
    Claimshark

    Ram Davaloor

    Founder and COO
    Claimshark
  • Author:

    Rena Bielinski

    VP Customer Success
    Codoxo

    Rena Bielinski

    VP Customer Success
    Codoxo
  • Author:

    Jesse Montgomery

    VP of Analytics and Data Science
    Codoxo

    Jesse Montgomery

    VP of Analytics and Data Science
    Codoxo

Other events you might be interested in:

2nd Annual Healthcare Payment & Revenue Integrity East

2nd Annual Healthcare Payment & Revenue Integrity Congress West