Ryan Pulver
Springfield
Summary
Over twenty years of experience in the Early Intervention Centralized Billing Services unit and with private insurance companies. Experience includes supervising the coordination of benefits unit, claims processing (receiving, reviewing, correcting), providing 2nd level technical support and direct sales in private insurance companies.
Overview
25
25
years of professional experience
Work History
Principal Consultant
Illinois State Board of Education
Springfield, IL
11.2024 - Current
- Reviews Federal Audit Reports from school districts, joint agreements and other entities in accordance with the uniform guidance.
- Reconciles financial data as needed, provides guidance to agency staff to assist in reviews of corrective action plans and drafting of management decision letters.
- Reviews financial audit reports from non-district grantees.
- Provides technical and other assistance via email, phone, written correspondence and workshops to certified public accountants, school district personnel, joint agreement administrators, regional superintendents and other administrators related to state and federal laws, regulations and governmental accounting/auditing standards.
Supervisor of Claims Processing – Coordination of Benefits Unit
Illinois Primary Health Care Association
Springfield, IL
10.2022 - 10.2024
- Coordinated with Department of Human Services to implement contract for Illinois Early Intervention Program, ensuring compliance and operational efficiency
- Supervised a team of four employees in their daily work and assured productivity within contractual guidelines
- Assisted staff, providers and other agencies regarding status of claims received, payment information, reports and benefit coverage
- Conducted staff training and produced written evaluations
- Prepared reports for Manager of the CBO and other duties as assigned
Supervisor of Claims Processing – Coordination of Benefits Unit
CQuest
Springfield, IL
11.2013 - 09.2022
- Coordinated with Department of Human Services to implement contract for Illinois Early Intervention Program, ensuring compliance and operational efficiency.
- Supervised a team of four employees in their daily work and assured productivity within contractual guidelines
- Assisted staff, providers and other agencies regarding status of claims received, payment information, reports and benefit coverage
- Conducted staff training and produced written evaluations
- Prepared reports for Manager of the CBO and other duties as assigned
Medicaid Reimbursement Specialist
CQuest
Springfield, IL
01.2013 - 11.2013
- Reviewed and adjusted Medicaid reimbursement claims to ensure accuracy based on analysis of remittance reports.
- Supported Claims Processing Supervisor in receiving and verifying provider billing forms for secondary claims processing.
- Assists in processing of provider refunds claims and family fee accounting
- Facilitated efficient processing of provider refunds and family fee accounting to support financial operations.
Claims Processor III
CQuest
Springfield, IL
09.2010 - 01.2013
- Performed initial and ongoing training of claim processors regarding benefit verifications
- Assisted Claims Processing Supervisor in efficiently receiving and storing benefit requests from Child & Family Connections (CFC) offices
- Processed claim adjustments based on supporting documentation to ensure compliance with guidelines
Claims Processor II
CQuest
Springfield, IL
09.2009 - 09.2010
- Processed, reviewed, and adjusted claims according to Central Billing Office policies, ensuring compliance and accuracy
- Communicated with insurance carriers and service coordinators to verify insurance benefits, facilitating timely claims resolution
- Investigated and resolved claim and waiver issues for providers, enhancing claim accuracy and provider satisfaction
Agent
Shelter Insurance Company
Springfield, IL
05.2008 - 07.2009
- Identified potential clients through market research and networking
- Delivered exceptional customer service to enhance client satisfaction
- Managed daily operations for insurance agency and small business to ensure seamless service delivery
- Achieved recognition as top newcomer in life insurance sales through exceptional performance
Sales Manager
Combined Insurance Company of America
Springfield, IL
01.2005 - 05.2008
- Prospected and acquired new customers to expand client base
- Cross-sold services to existing clients, enhancing their experience and loyalty
- Managed, recruited, and trained team of 2-5 sales agents to achieve sales targets
- Received multiple sales awards, including Gold and Platinum Pal, Pearl, Ruby, and Sapphire for exceptional performance.
Senior Water Technician
Illini Water Systems
Springfield, IL
12.2003 - 01.2005
- Conducted water chemistry tests to ensure compliance with safety standards
- Showcased filter product features to educate potential clients on benefits
- Prospected for new customers
- Provided ongoing support to existing clients
- Trained new hires
- Authored complete employee training manual and video
Graduate Intern
Illinois Environmental Protection Agency, Groundwater Section
Springfield, IL
08.2001 - 07.2003
- Coordinated with geologists to develop maps and fact sheets enhancing outreach for Federal Source Water Awareness Program
- Conducted data analysis and created graphs of radon samplings for comprehensive state-level assessments in Illinois
- Supported regulatory report preparation, ensuring adherence to environmental standards.
- Assisted in data collection for groundwater quality monitoring projects.
Education
Master of Science - Biology
University of Illinois
SpringfieldBachelor of Science - Biology and Chemistry with minor in Business Administration
Illinois College
JacksonvilleSkills
- Regulatory compliance
- Financial auditing
- Data analysis tools
- Customer service expertise
- Management expertise
- Team leadership & development
- Subject matter expert
- Problem-solving
Timeline
Principal Consultant
Illinois State Board of Education
11.2024 - Current
Supervisor of Claims Processing – Coordination of Benefits Unit
Illinois Primary Health Care Association
10.2022 - 10.2024
Supervisor of Claims Processing – Coordination of Benefits Unit
CQuest
11.2013 - 09.2022
Medicaid Reimbursement Specialist
CQuest
01.2013 - 11.2013
Claims Processor III
CQuest
09.2010 - 01.2013
Claims Processor II
CQuest
09.2009 - 09.2010
Agent
Shelter Insurance Company
05.2008 - 07.2009
Sales Manager
Combined Insurance Company of America
01.2005 - 05.2008
Senior Water Technician
Illini Water Systems
12.2003 - 01.2005
Graduate Intern
Illinois Environmental Protection Agency, Groundwater Section
08.2001 - 07.2003
Bachelor of Science - Biology and Chemistry with minor in Business Administration
Illinois College
Master of Science - Biology
University of Illinois