Provider Enrollment Specialist
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Committed, energetic, and results-oriented team player with exceptional customer relations and decision-making skills. Eager to contribute strong administrative abilities, a solid work ethic, and a professional demeanor to a growing organization.
Provider Enrollment Specialist - Artech
(2023-11)
Primary function is to manage the registration of new providers and the maintenance of existing provider information with government and commercial payers. Coordinate enrollment and re-enrollment processes, monitor provider status, and resolve issues related to claim submissions and denial management.
Project Coordinator Care Agent - SunPower
(2022-02 - 2023-11)
Primary functions are to assist direct homeowners, dealers, technicians, and installing partners by providing technical support through troubleshooting, customer support through updates, coordinating between the PC CARE TEAM and customers.
Premier Sales Consultant - AT&T of Austin Texas
(2021-08 - 2022-02)
Primary function includes providing optimum customer care while upselling premium services and products.
Office Administrator for Internal Logistics - Arcelor Mittal Steel
(2018-06 - 2021-08)
Primary functions include but are not limited to processing all pay for all business unit employees within Internal Logistics; schedule employees' work weeks and vacations; process pertinent Department of Transportation paperwork.
Utilities/Safety Advocate Coordinator - Arcelor Mittal Steel
(2018-06 - 2021-08)
Primary functions include but are not limited to procuring and testing EPA/OSHA approved personal protective equipment (PPE) for each individual on staff within the #3 Sinter Plant department for all electricians, mechanics, production staff, and managerial staff; create and implement safety procedures in direct correlation to PPE and job/environmental safety hazards within department; coordinate directly with outside vendors, contractors and departmental staff regarding PPE; operate Payloader/Front-loader which transport raw materials used for steel producing specifically for clients both local and international while observing and maintaining all safety protocol; Set up and oversee ongoing safety meetings, reports, and trainings; Correlate with international counterparts for wellness checks, shared vigilance compliance and Union Business; serve on the board of Women of Steel at Local 1010 Union; volunteer services to neighboring charities/organizations; volunteer contributing journalist for the five local union publications within the USA.
Science Diversity Office Secretary - Purdue University
(2018-02 - 2018-06)
Primary functions required that I serve as a liaison between the scholars and staff; grade and record assignments; set up meeting spaces and times; procure guest lecturers; mail out marketing literature; attend formal correlated functions as Science Diversity representative as well as typical day to day office management, clerical, duties.
Outreach Specialist- Anthem Medicaid - Engaging Solutions
(2017-05 - 2018-02)
Primary functions are to positively and effectively represent Anthem Medicaid by via marketing to their members and prospective clients. I sent up Anthem Medicaid booths with State- required brochures and promotional items, answer questions, problem-shoot, redirect members while working as a liaison between Sales, Marketing, Member Liaison, Health Education, Community Health Care Workers and other partners to meet both immediate and long-term cares and needs.
Drug Information Sales Account Manager - Wolters Kluwer Health
(2009-09 - 2016-10)
Procure new business for independent/retail pharmacies; Retail pharmacies within universities; small pharma, government accounts. Develop and maintain rapport/ relationships with existing client to renew and upsell existing accounts for MediSpan, Lexicomp, and Facts and Comparisons and Price Rx. Process billing, provide demonstrations and training, provide user statistics and resolution for high risk accounts; work closely with Legal to draft up license agreements, amendments and updated exhibits, set and negotiate pricing for all product lines and customers; handle the entire Mid-west territory plus, WV, NC, WI and Ontario.
Senior Professional Service Analyst - University Pediatrics Associates IU School of Medicine - Indianapolis, IN
(2007-06 - 2009-06)
Managed thousands of accounts receivable for patient accounts by performing accounts receivable duties including invoicing, cash application, researching charge-backs, discrepancies, issuing credit memos, reconciliations and responding to customer requests for documentation. Maintained and prioritized daily tasks and projects including: call logs, (few) appointments, posting payments received from patients, Insurances, and Collection Agencies; distributing mail to department members/staff/running credit card payments, accurately applying write-offs to appropriate invoices on patients' accounts, etc.
Claims Specialist/ Department Administrative Assistant - Indiana University IUPA, Inc - Indianapolis, IN
(2007-06 - 2009-06)
Assisted in all areas of administrative work including data entry, receptionist duties, file organization, research and development. Scheduled and confirmed appointments for Dr. Schmetzer (Director for EAP Psychological Services) and Dr.
Buckley (Director for Medical Students Psychological Services). Liaised with vendors to order and maintain inventory of office supplies. Managed incoming and outgoing calls for busy EAP lines and Medical Students Psychological Assistance lines. Processed accounts receivable and accounts payable for vendors. Managed hundreds of accounts receivable accounts working directly with the Financial Business Office (IUPA). Processed individual mental health claims, in-patient claims, and EAP claims, send out Explanations of Benefit letters, Denial Letters, and requests for additional information; contact providers and patients in response to concerns. Excelled in e-Cura programs for the use of processing claims, printing out EOBs, checking payments and remit advices, etc.… accurately using knowledge of CPT codes, ICD9's, Medical Terminology, etc. Maintained and prioritized daily tasks and projects including: call logs, appointments, claims, vendor p
Claims Specialist Medical-Dental - Anthem-WellPoint
(2005-01 - 2007-07)
Process Medical and Dental Claims. Ensure all claims are processed correctly as timely as possible.
Intakes to other departments to assist in recovering refunds for providers or members. Respond to inquiries, may involve customer/client contact. Make sure newborns names are added into the Facets system. Keep current Excel Spreadsheets of pending claims to periodically check on Processing progress. Aid in inventory reduction for both claims and intakes. Adequately proficient to maneuver around Facets, Ultera, Outlook, Excel, Learn Point, Lotus Notes, Outlook E-Cura, Mainframe, IDX, People Soft, and Sabre. Create relative folders for proper filing/storing on C and K drives. Verified and logged in deadlines for responding to daily inquiries and outlined the appropriate process and procedures necessary to fulfill and complete inquiries. (For newborn claims and any Aetna Medical/Dental claims). Standardized department filing system so secretarial staff could easily locate information in any filing center (for paper claims); Excelled within deadline-intensive environment, ensuring accurate and on-time completion of all projects.
Medicare Part D Customer Service Representative/Conflict Resolution Team Lead - Anthem-WellPoint
(2005-01 - 2007-07)
Updated patient accounts and information on a daily basis. Contacted insurance providers to verify correct insurance information and get authorization for proper billing codes. Reviewed and explained insurance plans to patients to guarantee full understanding of payment policies and procedures.
Researched aging reports including reimbursements which were 90 days in arrears status. Provided efficient customer service to clients. Performed regular telephone contact with providers to discuss status of re-billing and reimbursement process to ensure account resolution.
Handled, processed and distributed confidential patient information. Implemented new departmental policies and procedures for more efficient billing, consistently praised by management for the quality and timeliness of reports, attention to detail, exemplary customer service delivery and team-player attitude. Was assigned my own conflict/resolution staff of which I acted as Team Lead to a crew of 8.
Was promoted to Claims. One of two specially chosen to work inventory reduction of aged applications, Received various Kudos for outstanding customer service, Received Kudos for perfect Quality Assurance Score, entrusted to pe
Operations Expert - Tele-Services Direct
(1997-09 - 2004-08)
Consistently praised by management for the quality and timeliness of reports, attention to detail, exemplary customer service delivery and team-player attitude. Created databases and spreadsheets to improve inventory management and reporting accuracy. Excelled within deadline-intensive environment, ensuring accurate and on-time completion of all projects. Promoted from Sales Representative to Team/Shift Lead within first four months of employment. Promoted from Team-Shift Lead to Operations Expert within 6 months in new role.
Employee of the month three consecutive times.
