Antron Lamond Masden
Summary
Network Operations Coordinator 3 at Humana with a proven track record of exceeding production goals and achieving high-quality outcomes. Skilled in customer relationship management and problem-solving, I excel in streamlining processes and enhancing team collaboration, setting records for task submissions while maintaining meticulous attention to detail.
Overview
15
15
years of professional experience
Work History
Network Operations Coordinator 3
Humana
Lexington, Ky
10.2021 - Current
- APEX de-credentialing work case resolution and de-credentialing member notification for all provider types
- APEX de-credentialing work case resolution for all provider types (no mem notification)
- APEX work case submission for emails received by credentialing (re-cred/denials/de-cred)
- APEX work case submission for Facility/Ancillary Updates
- APEX work case submission (all LOBs) record cleanup
- Adds providers to existing groups
- Adds service locations to existing provider/group
- Credentialing verification support-BOT & outreach
- Directory updates/changes
- First Pass validation AKA Roster Scrub (CAQH/PMDM/C2P/CAS)
- GST build/cleanup SME/Maintenance
- Medicaid-PCP site visits
- Provider demographic updates (incl. print status)
- Provider leaving group / terminations
- Taxonomy specialty/subspecialty updates
- APEX submissions (within 5 business days)
- Maintaining all inventories (CRM, email, DCAV, De-Cred, PPG)
- Reports with deadlines, including Re-cred report, PPG K & G Par code report, PTN Governance reports, DDG Reports, Medicaid escalations & reports
- Set the record for most tasks submitted in a month
- APEX Routes/Rejects Remediation and Resolution
DCAV Specialist
Humana
Louisville, KY
04.2019 - 10.2021
- Achieve 96% or higher quality scores on all monthly audits
- Achieve 2.0 or greater on all month production audits
- Exceed production on both DCAV work and special projects while working both tasks at the same time
- Set the record for most tasks done in a week a year ago.
- Proficient in Humana systems such as SharePoint, PAAG, PMDM, EHUB and CAQH.
911 Emergency Police Dispatcher
Emergency 911
Lexington, KY
10.2018 - 04.2019
- Dispatched radio transmissions. Precise, clear and easily heard over the radio traffic.
- Answered incoming radio traffic - kept track of officers and locations.
- Tracked calls and handle times in order to ensure officer safety and call integrity. Updated all calls and used proper closing codes.
- Created traffic and stop tickets. Completed all tasks in a timely and accurate manner.
Senior Customer Relations Agent/Supervisor
OPC Pest Control
Louisville, KY
05.2012 - 10.2018
- Answered inbounds calls and decreased the time members spent on hold.
- Direct Contact for handling all complicated/difficult calls.
- Direct Contact for answering general pest questions.
- Leader in Sales on numerous occasions. Lead salesman in the call center.
- Met and exceeded sales and monthly goals
- Trained new customer service reps
- Team Lead/Supervisor for the Call Center
- Certified as a Subject Matter Expect for Bed Bugs, Termites and General Pest.
Customer Service
Connections
Jeffersonville, IN
09.2011 - 02.2012
- Processed Medicare claims.
- Handled prescriptions overrides and rejections.
- Provided medical plan overrides.
- Provided membership information.
Education
Some College (No Degree) - Religion
University of Northern Kentucky
Louisville, KYSome College (No Degree) - Chemistry, Anthropology
University of Louisville
Louisville, KYSome College (No Degree) - Anthropology
University of Louisville
Louisville, KYSkills
- Customer relationship management
- Effective communication
- Problem solving
- Time management
- Load balancing
- Team collaboration
Timeline
Network Operations Coordinator 3
Humana
10.2021 - Current
DCAV Specialist
Humana
04.2019 - 10.2021
911 Emergency Police Dispatcher
Emergency 911
10.2018 - 04.2019
Senior Customer Relations Agent/Supervisor
OPC Pest Control
05.2012 - 10.2018
Customer Service
Connections
09.2011 - 02.2012
Some College (No Degree) - Religion
University of Northern Kentucky
Some College (No Degree) - Chemistry, Anthropology
University of Louisville
Some College (No Degree) - Anthropology
University of Louisville