Experience

Bikham Healthcare

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

• Provider Relations Associate

  • Jul 2022 - Present



WellSpan Health

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

• Insurance Enrollment Coordinator

  • Nov 2020 - Sep 2021



McKesson

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

• Reimbursement Specialist

  • Apr 2017 - Jan 2020



Gateway Health Plan

• Provider Relations Representative

  • Dec 2005 - Feb 2016

  Acting liaison for participating providers of Gateway Health Plan network.•Responsible for assigned territory, conduct Environmental Assessments, educated providers on GHP policies/procedures, investigate claim issues, process demo/tax ID changes, and member complaints.•Assured all provider orientations, site visits, access and availability studies were completed within established time frames. •Established and fostered strong, positive relationships with key providers by coordinating and facilitating meetings and identifying on site enrollment opportunities. •Investigated and resolved member complaints regarding providers to maintain member and provider satisfaction. •Clarified the provider's problem; determined the cause; selected and explained the best solution to solve the problem and expedited correction or adjustment; followed-up to ensure resolution. Show less

• Credentials Specialist

  • Feb 2005 - Nov 2005

  Processed and evaluated initial and re-credential applications, primary source verification of provider/extender credentials ie: medical licenses, DEA, certificates, malpractice insurance and sanctions.•Prepared checklists for Medical Directors review, communicated with external credentialing contacts on a daily basis.



HealthAmerica/Aetna

• Credentials Specialist

  • Jul 2002 - Oct 2004

  Processed initial/re-credential applications, data-entry in Cactus, bulk mailing of approval letters. Processed initial/re-credential applications, data-entry in Cactus, bulk mailing of approval letters.