Angel Gantt
Warner Robins,GA
Summary
Experienced with managing provider relationships to ensure seamless communication and satisfaction. Utilizes problem-solving skills and negotiation techniques to resolve conflicts and enhance service delivery. Knowledge of healthcare regulations and administrative processes, ensuring compliance and operational efficiency.
Overview
5
5
years of professional experience
Work History
Provider Relations Representative
New Directions Behavioral Health
Warner Robins, GA
08.2024 - Current
- Facilitated communication between providers and internal departments to enhance service delivery.
- Resolved provider inquiries efficiently, ensuring high levels of satisfaction and engagement.
- Coordinated training sessions for new providers on system usage and best practices.
- Maintained comprehensive records of provider interactions using CRM software for streamlined access.
- Assisted providers in navigating through various reimbursement processes, resulting in timely payments and reduced financial disputes between parties.
- Served as a liaison between healthcare organizations and insurance companies to ensure seamless communication regarding claims processing and payment matters.
- Reduced claim disputes by effectively communicating policy changes and updates to providers.
Medical care program associate II
Priority one staffing/ Maryland Department of Health
Baltimore, MD
11.2023 - 08.2024
- Managed and updated customer records using the Maryland Management Information System (MMIS), ensuring accurate entry of eligibility changes and updates.
- Processed Medicaid card requests and maintained compliance with program standards using MMIS.
- Reviewed and verified member coverage using the Eligibility & Enrollment (E&E/CARES) system, applying Medical Assistance eligibility guidelines with precision.
- Resolved eligibility issues and responded to service inquiries through the Maryland DHS Customer Relations Management (CRM) system, improving member satisfaction.
- Verified recipient eligibility through the Maryland Health Connection (MHC) to ensure accurate and up-to-date healthcare coverage.
Customer Relations Specialist
CVS Health
Baltimore, MD
05.2020 - 11.2023
- Handled 50–80 inbound calls daily, assisting customers with prescription orders, insurance questions, and general pharmacy inquiries.
- Processed and fulfilled prescriptions by entering data into the pharmacy system and maintaining accurate patient records.
- Verified insurance benefits and completed necessary forms to support prescription coverage and billing.
- Filled and shipped prescriptions and supply orders while ensuring compliance with safety and privacy regulations.
- Provided knowledgeable support on over-the-counter medications and assisted with prescription intake over the phone.
- Performed clerical functions including filing customer records, processing payments, and maintaining organized documentation
Education
High school - General studies
Calvert high school
Prince Frederick, MD05.2015
Skills
- Customer service
- Communication skills
- Computer literacy
- Microsoft
- Documentation review
- Time management
- Microsoft word
- Leadership
- Application processing
- Claims reviewing
- Health plan operations
- Provider support
- Strategic business relationships
- Call center experience
- Data entry proficiency
Timeline
Provider Relations Representative
New Directions Behavioral Health
08.2024 - Current
Medical care program associate II
Priority one staffing/ Maryland Department of Health
11.2023 - 08.2024
Customer Relations Specialist
CVS Health
05.2020 - 11.2023
High school - General studies
Calvert high school