Experience

Alliance Health

• United States
• Hospitals and Health Care
• 500 - 600 Employee

• Provider Network Development Specialist

  • Dec 2021 - Present



Cardinal Innovations Healthcare

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

• Network Specialist 2

  • Nov 2019 - Oct 2021

• Network Specialist

  • Feb 2017 - Oct 2019

• Contracts & Credentialing Coordinator

  • Apr 2014 - Feb 2017

  • Responsible for high-level data input and analysis pertinent to new contracts, contract amendments, provider credentialing information and member updates requested by the Network Operations Department• Responsible for time-sensitive projects such as data testing for system upgrades and reviewing processes and procedures to determine edits in CI (company billing and information system) • Responsible for performing internal quality monitoring activities to foster data integrity, minimal error ratios that result in claim denials, and trend analysis regarding continuous quality improvement opportunities• Responsible for interfacing with MCO Network Operations staff regarding various enrollment/contractual requests.



Mecklenburg County

• United States
• Government Administration
• 700 & Above Employee

• MeckLINK Senior Quality and Training Specialist

  • 2013 - Mar 2014

  • Coordinated and processed administrative and clinical denials involving MeckLINK enrollees and providers• Responsible for completion of the denial process including letter creation, printing, tracking and disposition within contractual guidelines to ensure State and MCO compliance• Responsible for compliant turn-around time-frames for all denial and/or appeal notifications

• MeckLINK Case Coordinator

  • Nov 2012 - Jun 2013

  • Created a tracking system for monitoring inpatient hospital admissions for all Mecklenburg County Medicaid recipients• Responsible for daily analysis of the hospital census for all community hospitals and out-of-network hospitals with Mecklenburg County Medicaid recipients admitted• Responsible for Quality Assurance standards and data integrity of consumer charts and hospital Care Coordination checklists



Windstream

• United States
• Telecommunications
• 700 & Above Employee

• Sales Consultant

  • May 2011 - Jul 2012

  • Consistently brought over $11,000 per month in new revenue and Top 10 status in overall sales on a monthly basis • Provided excellent customer service to Windstream clientele with the ability to build rapport, engage consumers and sell products with a high close rate (on average 40% close rate and in the Top 10 monthly) • Consistently brought over $11,000 per month in new revenue and Top 10 status in overall sales on a monthly basis • Provided excellent customer service to Windstream clientele with the ability to build rapport, engage consumers and sell products with a high close rate (on average 40% close rate and in the Top 10 monthly)



Convergys

• United States
• Outsourcing and Offshoring Consulting
• 700 & Above Employee

• Account Executive

  • Aug 2010 - May 2011

  -Offered technical support to cable customers and if needed prepared complete and accurate work-orders to help facilitate a timely remedy to their situations -Communicated effectively with individuals/teams in the program to ensure high call quality. -Contributed ideas on ways to resolve issues to better serve the customer and improve productivity -Offered solutions to basic customer needs. Maintained knowledge of client products and services. Responsible for up-selling lines of business such as Video, Internet and Phone by communicating features and benefits -Reviewed billing statements to customer satisfaction and ensured a timely and accurate remedy to all issues



ARJ, LLC

• Community Support Team- Team Leader

  • Jan 2010 - Jun 2010

  -Evaluated all new clients during initial intake process and completed screening assessments -Developed all Person Centered Plans that outlined the client’s goals and course of treatment -Managed all team functions such as scheduling, billing, and authorizations for each client -Supervised all Associate and Para Professionals assigned to team -Facilitated weekly team meetings and monthly one-on-one supervisions with staff -Prepared monthly billing reports for upper management staff -Guided a 100% adult mental health population and helped them to achieve their personal goals



Be Well Therapy, PLLC

• Community Support Team Supervisor

  • Jul 2009 - Jan 2010

  -Supervised direct workers within the Community Support Team to ensure that all clients received adequate and appropriate services -Devised a detailed authorization tracking system for the company -Created an efficient billing schedule for all staff resulting in a 50% reduction in documentation and billing errors -Facilitated weekly staff meetings to discuss client progress, setbacks, and upcoming goals to work with the consumer on for the next week -Directed clients and counseled them on the goals they specified and provided community support services each week in the form of face to face interactions, coordinating services and linking them to the appropriate community resources -100% Adult Mental Health population



Melange Health Solutions

• United States
• Mental Health Care
• 1 - 100 Employee

• Client Care Counselor

  • Jan 2009 - May 2009

  -Coached, counseled, and coordinated services to children and families in the home, school and community -Provided exceptional customer service to all clients and acted as a liaison between clients and key players within the community -Scheduled and facilitated monthly Team meetings -Developed individual Person Centered Plans for each client -Documented client progress and setbacks daily and input information into the client’s charts -Facilitated monthly client satisfaction surveys and provided monthly reports to upper management staff -90% child / adolescent mental health population and 10% adult mental health population



Ultimate Care, LLC

• Intake Specialist

  • Jan 2009 - Jan 2009

  -Streamlined the intake process by meeting with all new client’s and scheduling initial assessments -Created an online calendar and a documentation tracker for Case Managers and Therapist which decreased missed deadlines by 50% in the first 30 days -Completed all intake paperwork and sent all information to the local management entity for review -Streamlined the intake process by meeting with all new client’s and scheduling initial assessments -Created an online calendar and a documentation tracker for Case Managers and Therapist which decreased missed deadlines by 50% in the first 30 days -Completed all intake paperwork and sent all information to the local management entity for review



One Love Services

• Qualified Professional

  • Mar 2007 - Dec 2008

  -Offered client assistance specific to the consumer’s needs in order to ensure the most effective and appropriate services were being rendered -Empowered individuals by presenting resources pertaining to employment, education, housing, mental health, substance abuse, and parenting needs -Worked directly with the consumers on the goals they specified and provided community support services each week in the form of face to face interactions, coordinating services and linking them to the appropriate community resources -80% Adult Mental Health population / 20% Adolescent Mental Health population



Beatties Ford Family Counseling Center

• Case Manager

  • Aug 2006 - Feb 2007

  -Linked individuals with resources pertaining to employment, education, housing, mental health, substance abuse, and parenting needs -Worked directly with the consumers on the goals they specified and provided community support services each week in the form of face to face interactions, coordinating services and linking them to the appropriate community resources -75% Adult Mental Health population / 25% Adolescent Mental Health population -Linked individuals with resources pertaining to employment, education, housing, mental health, substance abuse, and parenting needs -Worked directly with the consumers on the goals they specified and provided community support services each week in the form of face to face interactions, coordinating services and linking them to the appropriate community resources -75% Adult Mental Health population / 25% Adolescent Mental Health population



Youth Villages

• United States
• Philanthropic Fundraising Services
• 700 & Above Employee

• Family Counselor

  • Nov 2005 - May 2006

  -Provided families with treatment to help them accomplish their specific needs -Identified personal and interactive problems and provide individual, family counseling and case management services to child and family in the home -80% child/adolescent mental health and 20%MR/DD population -Provided families with treatment to help them accomplish their specific needs -Identified personal and interactive problems and provide individual, family counseling and case management services to child and family in the home -80% child/adolescent mental health and 20%MR/DD population