Experience

Lumeris

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Provider Data

  • Apr 2018 - Present

  • Loading of provider demographic data either through manual or automated process of initial provider records into provider data management system for provider directory and claims payment purposes. • Loading of non-participating provider demographic data from either paper or electronic claims for claims payment purposes • Research, review and make updates within the provider data management system per provider requests • Outreach to provider offices to validate demographic information meets CMS compliance regulations • Perform quality service checks on provider data inclusive of claims processing and provider directory information • Perform research and resolve provider data issues as necessary Research and resolve issues of provider return mail from various departments • Validation and entry of provider tax information from receipt of W9 • Uploading of provider contracts and demographic forms into company SharePoint site • Validation and entry of provider electronic payment and remit status from various sources Show less



Essence Healthcare

• United States
• Hospitals and Health Care
• 100 - 200 Employee

• Customer Service Representative

  • Jan 2016 - Present

  • Research and analyze claim data daily as requested by Customers and external parties. • Maintain HIPPA standards of privacy and security of customer information. • Responsible for quoting precise information to providers and members. • Performs data entry and retrieval of customer data. • Communicates frequently with clients and provider in a respect professional manor • Completes special projects requested on time/ahead of schedule. • Access and utilized multiple computer programs with high proficiency. • A team player that demonstrates excellent customer service skills. • Proven monitored and recorded patient satisfaction. • Skilled in Facets , ESI and Med –Impact Show less