Job Search Status
Open to workDesired start date: Immediately
Open To Work
Angela Lewis
Summerfield,NC
Work Preference
Summary
Dynamic healthcare operations professional with over 24 years of experience in provider data management, client relations, and claims processing. Expertise in serving as a vital liaison among clients, vendors, and internal teams to ensure seamless communication and collaboration. Recognized for delivering timely and accurate responses while driving process improvements, demonstrating strong organizational skills and adaptability. Committed to fostering a supportive environment that enhances operational efficiency and client satisfaction.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Claims Business Process Analyst
United Healthcare
11.2022 - Current
- Liaison for clients, vendors, and internal teams to resolve claims and data issues.
- Respond to client/provider inquiries within compliance guidelines.
- Maintain records and create operational reports.
- Adapt to new platforms and processes.
- Update CMS portal with requested information for No Surprise Bill Act (NSA) complaints.
- Completed determinations on NSA complaints for results to be sent to arbitrators.
- Engaged in process improvement conversations to change workflows for the team.
- Provide requested documentation to arbitrators to assist in decision making for the NSA process.
- Submit renegotiation requests to repricing vendors to ensure proper payment adjustments.
- Trained additional staff on submissions to repricing vendors.
- Facets claim platform knowledge
Supervisor, Inventory Management
United Healthcare
05.2022 - 11.2022
- Managed workload and resources in a fast-paced setting.
- Led database and process improvements.
- Trained staff in new procedures.
- Inventory management.
- Maintained response deadlines.
- Secured document for staff to complete work.
Senior Provider Reimbursement Representative
United Healthcare
06.2018 - 05.2022
- Supported claim review and network reporting.
- Resolved payer issues and improved compliance.
- Processed high dollar Home Health Claims
Education
Bachelor of Science - Biology
University of Arkansas At Pine Bluff
Pine Bluff, AR12-1994
Skills
- MS Office Suite,
- Effective communication
- Process change management
- Proficient in claims Platforms, Workflow Systems, EDI (834 & 837), PowerBI, Tableau, SharePoint, Google Suite, Facets System
- Procedure updating
- Meeting participation, Excellent communication, active listening, verbal and written communication
- Self motivation
- Process change improvements, organizational skills,
- Operational excellence
- Team building and motivation, teamwork, team collaboration, team leadership
- Business analysis
- Teamwork and collaboration
- Attention to detail
Certification
- NPS Certification
- IBM Data Analytics Certification
Core Competencies
- Client Relationship Management
- Processing Claims (Professional, Facility, Ancillary)
- Provider & Vendor Communication
- Regulatory Compliance
- Process Documentation
- Team Collaboration
- Problem Solving
- Technical Applications (MS Office, Claims Platforms)
Key Accomplishments
- Reduced credentialing process time by 20%
- Cut data quality issues by 30%
- Achieved 100% audit compliance
- Delivered reports that improved operations
Timeline
Claims Business Process Analyst
United Healthcare
11.2022 - Current
Supervisor, Inventory Management
United Healthcare
05.2022 - 11.2022
Senior Provider Reimbursement Representative
United Healthcare
06.2018 - 05.2022
Bachelor of Science - Biology
University of Arkansas At Pine Bluff