Dr. Nahra, President and Co-founder of Health Decisions, Inc., is a respected advisor to employers, insurers, health maintenance organizations, self-funding administrators, and Blue Cross Blue Shield plans.
His professional experience in the US health care system began in the early 1970s. It spans work for three states and the federal government where he worked as a program review and audit specialist. Within the private sector Dr. Nahra worked with non-profit health systems and business coalitions as a director of research and policy analysis.
Since 1985 with the founding of Health Decisions, Inc., he has worked in the group health market where he has delivered hundreds of successful health plan audits. Under his leadership, Health Decisions has led the market in auditing innovations. The Company was one of the earliest adopters of 100% claim audits using data mining technologies. It set precedents for the inclusion of recovery collections as a part of a modern claim audit. Health Decisions introduced enrollment auditing to its clients 15 years before its more general adoption as a fundamental part of benefits auditing. The firm develops new audit modules each year. Health Decision's software suites continue to set new audit performance standards.
Dr. Nahra has authored numerous pieces on various aspects of health care auditing that will also be featured on his blog "Si's Library." Most recently, he authored the chapter on Health Benefits Auditing in the book "Cost Recovery: Turning Your Accounts Payable Department into a Profit Center" by Richard B. Lanza, CPA, CFE, PMP.
Si hosts regular monthly webinars covering various topics related to auditing group health expenses. He has spoken at numerous conferences and is frequently invited to host training and background sessions for health care advisory, brokerage and consulting organizations. Dr. Nahra has a bachelor’s degree from Colby College and a Ph.D. in political science from Michigan State University.
Judy L. Mardigian, Chief Executive Officer
Ms. Mardigian, Co-Founder and CEO of Health Decisions, Inc., heads the firm’s finance, enrollment auditing service, and claim recovery service activities. Her ability to understand employers’ challenges in oversight of health plan administration led her to develop the methodology for the company’s Comprehensive Medical Claims Audit and Enrollment Audit Services. Ms. Mardigian is currently the Audit Practice Leader for the firm’s Enrollment Reconciliation Audit Service, conducted for large complex employer-sponsored health plans and trusts.
Prior to founding Health Decisions, Ms. Mardigian was a Senior Account Manager for MEDSTAT Systems where she managed the service delivery for Fortune 500 clients, such as General Electric, TWA, and B.F. Goodrich. She is also past President and a twelve-year elected board member for the Plymouth-Canton Community Schools, the fourth largest district in the State of Michigan. Judy has a bachelor’s degree in social science from Michigan State University where she also completed her master’s coursework in health communications.
Tina Pelland, MA, Audit Practice Leader
Ms. Pelland leads the Administrative Overpayment Audit service analysis team and is responsible for client service delivery. She has expert knowledge of the myriad of rules and regulations governing post-payment recovery. Ms. Pelland has been with Health Decisions since 1994, and has developed innovative procedures for verifying information and documenting facts that were not recognized at the time of payment and is an expert at negotiating recovery collections. Tina has a bachelor’s degree from Michigan State University, and a master’s degree in human resources from Wayne State University.
Leslyn Rank, Finance Manager and Eligibility Audit Practice Leader
Ms. Rank has been with Health Decisions since 1997, and has been managing Dependent Eligibility projects for the past eight years. She also leads the design of the communication and survey forms. In addition to her strong background in finance, she has led the development and refinement of the dependent verification mailing process. She earned a Bachelor of Fine Arts from Grand Valley State University.
Roberta Johnson, Audit Analyst
Ms. Johnson coordinates all Dependent Eligibility Audit project activities and focus enrollment mailings for Health Decisions’ clients. She specializes in managing all data intake processes for Health Decisions’ audit projects, including data requests and data assessment. Prior to joining Health Decisions in 2000, Ms. Johnson worked for The Bendix Corporation and in the health insurance industry. She earned a Bachelor of Science in Business Administration at Mercy College of Detroit.
Monika Blazeski, Accounts Manager and Analyst
Ms. Blazeski’s work includes Dependent Eligibility Audit data intake and processing, participant communications, audit reporting, and Affordable Care Act compliance monitoring. Ms. Blazeski has a bachelor’s degree from the University of Michigan and is a Certified Health Care Reform Specialist.
Matt Puls, SQL Developer
Mr. Puls joined Health Decisions in 2013. His main responsibilities concern the processing of Claim Recovery and Dependent Eligibility data. Matt earned a Bachelor of Science in Informatics from the University of Michigan.
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