About Our Company
Performant Recovery works with government and private organizations that outsource the identification of overpayments and underpayments to agencies whose core competencies are in the efficient and thorough examination and resolution of healthcare related assets. Performant Recovery is dedicated to providing organizations that have practical consideration for not just the immediate identification of underpayments and overpayments that may have resulted from erroneous, fraudulent, or wasteful procedures, but also aim to successfully recover all necessary overpayments within a set timeframe and budget. Performant Recovery can also provide other professional services related to the recovery effort, including reporting capabilities, support services, and stakeholder training programs meant to mitigate future instances of improper payments.
Performant Recovery employs specialized processes to ensure that improper payments are quickly identified and resolved in a fair and equitable manner for all parties involved. Performant Recovery also helps promote outreach efforts and forums to apprise the public and healthcare providers of the nature of a particular program and to gain their understanding and cooperation in determining the correct outcome of the disbursement of payments.
Prior to the release of the most recent competitive Recovery Audit Contract bid, Performant Recovery was awarded a three-year contract for the Medicare Secondary Payer (MSP) RA Demonstration contract of California by the Center for Medicare & Medicaid Services (CMS). In a final report, an independent committee found that Performant Recovery was responsible for over 90% of the dollars recovered by recovery specialists for the MSP RA demonstration.
In 2008, Performant Recovery received the CMS Recovery Audit (RA) award based on its familiarity with CMS and its proven track record of quick and thorough recovery efforts. Under the RA contract, Performant Recovery will assist providers in reducing Medicare improper payments, and help eliminate waste and abuse within the Medicare program.
Roxanne Cooksey, Project Director
Roxanne Cooksey is the Project Director for RA Region A. Roxanne has over 10 years of experience in the healthcare industry. During this time, she has managed and directed special projects and implementations. She has a strong track record of managing timely, complete, and accurate project deliverables as it relates to adherence to policy, regulatory compliance, contracts and statements of work. She continues to oversee the RA Healthcare Operations and Customer Service team in the San Angelo office and is actively involved in supporting Audit Delivery Functions. Overall, Ms. Cooksey is responsible to ensure the implementation of the RA contract meets CMS requirements and the development of a good working relationship with all interested parties.
Dr. Marlene Mullen-Clayton, Chief Medical Director
Dr. Mullen-Clayton serves as Chief Medical Director for Perfomant Recovery, Inc. She brings an extensive array of healthcare experience as an academician, physician and corporate leader.
Prior to joining Performant, Dr Marlene Mullen-Clayton was the Northeast Regional Medical Director at United HealthCare focused on NJ managed Medicaid acute inpatient, skilled nursing facility, long term acute care hospital and acute inpatient rehabilitation services. In this role, and in her previous role as Chief Medical Officer of Premier Healthcare Exchange (PHX), Dr. Mullen-Clayton supported value based healthcare through medical necessity and policy review, peer interaction, and stakeholder educational presentations. Prior to joining PHX, Dr. Mullen-Clayton served as the Vice President of Medical and Clinical Operations for Executive Health Resources/Optum where she was a leader in the Strategic and Tactical Advocacy Team. This team supported clients through OIG and DOJ investigations and developed concepts, products, and position statements for internal and external clients. Prior to this, she managed the commercial appeals team and performed Medicare compliance reviews and appeals as a physician advisor for acute care hospitals across the country.
Dr. Mullen-Clayton has nearly 20 years of clinical practice experience as an Emergency Medicine Physician and Medical Director. She has held associate faculty positions at Thomas Jefferson University School of Medicine, MCP-Hahnemann School of Medicine and Drexel University. Dr. Mullen-Clayton received her medical degree from the Philadelphia College of Osteopathic Medicine and her MBA from the University of Massachusetts Amherst. She is Board Certified in Emergency Medicine and is a Fellow of the American Association For Physician Leadership.
Deborah Wilhelm, RN
Deborah Wilhelm, a registered nurse and certified medical coder, leads the Performant Recovery Healthcare New Issue Development Team. Ms. Wilhelm has a proven track record of leading a virtual team. She is an expert in the Medicare program, including interpreting regulations, policy requirements, claims processing editing, and management of projects and day-to-day operations. Ms. Wilhelm has thorough knowledge of CPT, HCPCS and ICD-9-CM coding and certified ICD-10-CM and ICD-10-PCS trainer. She also has experience as a Clinical Research Coordinator.