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Skills

  • Escalation management
  • Operational efficiency improvement
  • Time management
  • Cost reduction strategies
  • Healthcare Provider Engagement
  • Business operations
  • Process optimization
  • Stakeholder engagement
  • Provider Dispute Resolution
  • Performance metrics reporting

Work Experiences

  • Achieved a 60% retention rate.
  • Achieved improvements over several months.
  • Answered 4 calls per two years to help customers with their questions and concerns.
  • Analyzed and resolved complex provider inquiries, maintaining a 31% satisfaction rate in 2016.
  • Achieved an Innovation Award for Outstanding Provider Relations.
  • Achieved actionable results.
  • Achieved savings across several months.
  • Gathered, organized, and entered data into a database system.
  • Added 10 new service facilities.
  • Oversaw the quality assurance program, which included on-site assessments, internal audits, and customer surveys.

Summaries

  • Accomplished in resolving escalated provider issues with a 46% success rate, utilizing effective active listening and targeted mediation techniques. Demonstrated excellence in conflict resolution and provider retention.
  • Accomplished Senior Provider Relations Advocate.
  • Senior Provider Relations Advocate with 3 years of successful workflow optimization and client relations experience.
  • Achieved a 81% enhancement in provider satisfaction.
  • Advocated for providers' needs.
  • Achieved a 62% reduction in service complaints.
  • Achieved minimal disruption.
  • Achieved network satisfaction improvements of over 62%.
  • Achieved high provider retention.
  • Ambitious professional with a passion for relationship management.

Accomplishments

  • Secured strategic partnerships with 15 high-impact provider partners, driving a 37% increase in provider network satisfaction.
  • Implemented a process optimization framework that reduced resolution time for standard provider issues by 69% hours.
  • Championed a custom-built provider dashboard, enhancing visibility of performance metrics, resulting in a 35% faster reporting process.
  • Analyzed trends in provider claims data to predict future issues, implementing preventive measures that decreased claims reprocessing by 23%
  • Fostered improvement in satisfaction rates by 69% through mentoring new team members and formalizing internal training structures for provider handling.
  • Led the adoption of a provider feedback loop, increasing provider satisfaction survey participation by 44% over three years.
  • Played an integral role in the cross-functional launch of a new provider relations platform, resulting in 82% better data accuracy in tracking claims.
  • Reduced escalated provider complaints by 19% through effective mediation and conflict resolution techniques.
  • Led communication efforts that resulted in a 80% higher rate of provider engagement in network-wide changes and policy updates.
  • Documented and resolved procedure which led to standard.

Affiliations

  • Association of Information Technology Professionals
  • Lions Club
  • Patient Advocate Certification Board (PACB)
  • Project Management Institute
  • American Medical Billers Association (AMBA)
  • National Rural Health Association (NRHA)
  • Jaycees
  • National Association for Healthcare Quality (NAHQ)
  • American Medical Informatics Association
  • American Health Information Management Association (AHIMA)

Certifications

  • Certified Public Accountant
  • Healthcare Claims & Dispute Resolution Expert Certification – Vantage
  • CompTIA Security+
  • Certified in Provider Network Management – Summit Group
  • Certified Provider Credentialing Specialist (CPCS) – National Association Medical Staff Services
  • Six Sigma Green Belt Certification – Northwind
  • First Aid/CPR Certified
  • Conflict Resolution Certification Brightline 2023
  • CompTIA Network+
  • Certified Managed Care Professional (CMCP) – 2020

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