Danielle Wong

Oversees a Lead Medical Analyst team of 30+ staff, accountable for quality, production, training, staffing, and technical enhancements to the data management platform to improve throughput and accuracy.

Supported medical operations and supervision, led quality initiatives and training for analyst teams, and contributed to production targets and guideline development.

Supervised medical analyst teams, provided SME training, led QA efforts, and produced MSA determinations for workers' compensation and liability claims.

Determined future medical costs for worker’s comp and liability claims through electronic medical record review, coding identification, and pricing using WC fee schedules and AWP.

Managed daily oversight of MSA review analysts and coding teams, accountable for quality, production, and team performance for Medicare Set Aside reviews.

Performed MSA allocations, secondary audits, and responded to client allocation inquiries while ensuring accuracy of future medical cost determinations.

Led QA initiatives for a Medicaid managed care organization, coordinated state audit preparations, conducted provider site reviews, and managed sentinel event evaluations.

Provided litigation support through medical record abstraction and chronologies for class action lawsuits, identifying undisclosed providers and preparing discovery materials.

Supervised CMS data abstractors, ensured accuracy on national priority topics, implemented corrective actions, and developed abstraction guidelines and tools.

Provided critical care nursing in the Medical ICU as a float pool staff nurse, delivering high-acuity patient care and participating in unit protocols and training.

Delivered bedside critical care in the Medical ICU, performed charge nurse duties and served as a preceptor for new nursing staff.

Provided post-anesthesia and progressive care nursing, participated in policy and procedure committees, and supported postoperative patient management.

Earned a Bachelor of Arts in Health Care Administration from Graceland College in Lamoni, Iowa.

Completed a Diploma in Nursing at Lankenau Hospital School of Nursing in Wynnewood, PA.

Completed an Associate of Arts at Eastern College in Saint Davids, PA.

Certified as a Medicare Set Aside Certified Consultant (MSCC).