Skills • Intermediate Proficiency in MS Excel, Outlook, WebEx

• 8 years data analysis and research experience

• 8 Years credentialing experience including Medicare and Commercial

• 6 months medical billing experience including billing/payments

• Fast typist (WPM: 75); Very Good 10-Key

• Strong organizational and interpersonal skills, Very patient, and detail oriented

Experience

Broad-Path Healthcare Solutions September 2013

to Present

Provider Data Analyst (UHC) January 2016 to present

• Solve moderately complex problems and conducts moderately

complex analyses

• Responsible for various activities related to the provider

network database: extracting data for various reports and

analyses

• Work with minimal guidance

• Performing comprehensive data and contract reconciliations

across platforms

Provider Enrollment Specialist September 2013-

December 2015

• Processing CMS Medicare Part B applications for JF & JE, paper

& web.

• Training assistant with Medicare Part B PE training on 855B

applications

• Side-by-Side mentoring/coaching to new hires

• Performed Quality Assurance (QA) audits on new hires

• Writing documentation of PE processes for training

Alorica (Call Center) – AT&T Wireless customer service rep May 2013-

September 2013

Unemployed due to relocating from Florida to Georgia December 2012 to

May 2013

Novitas Solutions, Inc. (CMS MAC contractor) July 2012 to Dec.

20, 2012

Technical Assistant

• Coaching/Mentoring/Auditing – Assist Medicare Provider Enrollment

Credentialist with questions pertaining to procedures, regulations, and in

processing CMS-855 applications.

First Coast Service Options, Inc.(CMS MAC contractor) October 2008 –

July 2012

Provider Enrollment Specialist

• Screen, validate and process sensitive information given by providers

• Conduct research, resolve problems and respond to telephone and written

inquiries from providers. Identify cases of suspected fraud

• Verify information and credentials supplied by the applicant

• Research and develop for additional information as needed to complete the

enrollment application. Act as customer service liaison to ensure that complex

issues are resolved timely

• Interact daily verbally or in writing with physicians, attorneys, and billing agents

• Create an enrollment record in the Provider Enrollment Chain Organization

System (PECOS)

FlagShipMD (Billing Agency) May 2008 to

October 2008

• Responsible for filing secondary insurance claims

• Interact daily verbally or in writing with physicians, patients/beneficiaries, and

insurance companies to attain payment and /or claim information

• Credentialing for physicians for enrollment in various insurance companies

Shands Hospital Orthopedics Clinic (Externship) March

&April 2008

• Trained on office systems

• CPT-Coding, ICD-9 Coding

• Computer processing, filing

Convergys Corporation (Call Center) October 1995 to

October 2007

Team Leader

• Supervisor of team customer service representatives for the Clairol client

• Various duties including monitoring, coaching/feedback, attendance issues,

performance reviews, call escalations, ensure all phone line are appropriately

staffed at all times.

Education

Everest University in Jacksonville, Florida – Medical Insurance Billing & Coding November 2007

to June 2008