Experience

Buckeye Health Plan
• United States
• Hospitals and Health Care
• 100 - 200 Employee
• Data Integrity Specialist

  • Mar 2022 - Present


Advantum Health

• United States
• Hospitals and Health Care
• 200 - 300 Employee

• Privileging Specialist

  • Feb 2021 - Mar 2022

  Manage application process for providers seeking privileges with hospitals Hold weekly meetings with assigned clients to address action items relating to provider hospital privileges Follow up with multiple contacts to ensure applications for hospital privileges are completed correctly and within expected turnaround times Develop and revise processes to optimize efficiency and ease of processes for assigned clients Manage application process for providers seeking privileges with hospitals Hold weekly meetings with assigned clients to address action items relating to provider hospital privileges Follow up with multiple contacts to ensure applications for hospital privileges are completed correctly and within expected turnaround times Develop and revise processes to optimize efficiency and ease of processes for assigned clients



Molina Healthcare

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Associate Analyst, Provider Configuration Management

  • Jan 2021 - Feb 2021

  Perform pre-screening actions to verify provider credentials (license, sanctions, NPI, etc) prior to configuration Configure, maintain, and audit provider data within claims system Link providers to proper contracts and affiliation networks Determine contract effective and termination dates based on provider medicaid certification Update multiple databases and tracking records with acute attention to detail Perform pre-screening actions to verify provider credentials (license, sanctions, NPI, etc) prior to configuration Configure, maintain, and audit provider data within claims system Link providers to proper contracts and affiliation networks Determine contract effective and termination dates based on provider medicaid certification Update multiple databases and tracking records with acute attention to detail



Evolent Health

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

• Key Provider Representative, Provider Data Management

  • Jun 2020 - Jan 2021

  Act as primary point of contact between assigned providers and health planCoordinate across multiple departments to manage all enrollment requests and projects for 15 priority provider groupsInvestigate claims and enrollment issues and provide timely responses/solutionsAudit provider data to ensure accuracy across multiple databases and reportsConfigure, maintain, and audit provider data within claims system, linking to proper contracts and affiliation networksTroubleshoot enrollment and claims issues by cross-referencing against multiple databases and tracking recordsEducate providers regarding policies and procedures related to claims submission and enrollment requestsTrain peers and new staff on enrollment processes/best practices Show less

• Coordinator, Provider Data Management

  • Nov 2019 - Jan 2021

  Accept and process healthcare provider applications.Troubleshoot miscommunications between various technological systems and reports



Bluegrass Cellular

• United States
• Telecommunications
• 100 - 200 Employee

• Support Services Coordinator

  • Aug 2018 - Nov 2019

  Payroll (taxes, garnishments, deductions, merit increases) Worker's Compensation Program and maintain federally required records Coordinate Safe Driver Program Manage company fleet Manage staffing agency relationships Create trainings in company talent management system (Bridge) Employee background screens Employment Verifications Payroll (taxes, garnishments, deductions, merit increases) Worker's Compensation Program and maintain federally required records Coordinate Safe Driver Program Manage company fleet Manage staffing agency relationships Create trainings in company talent management system (Bridge) Employee background screens Employment Verifications



Apex Plumbing

• United States
• Specialty Trade Contractors

• Administrative Assistant

  • Sep 2017 - Aug 2018

  Perform preliminary phone screens for all applicants Configure, audit, and manage employee data within HRIS (Quickbooks) Maintained excel records of employee attendance/absences Coordinated scheduling of service calls, delegating tasks to best-suited employees Processed and administered payroll on a weekly basis Perform preliminary phone screens for all applicants Configure, audit, and manage employee data within HRIS (Quickbooks) Maintained excel records of employee attendance/absences Coordinated scheduling of service calls, delegating tasks to best-suited employees Processed and administered payroll on a weekly basis