Brandi Lawrence
Parma,Ohio
Summary
Seeking advancement as Business Analyst to capitalize on my current 5+ year analytical skills at delivering data-driven recommendations and reports to directors and executives. Extensive experience in healthcare compliance and continuous improvement principles in data integrity and quality functions line across the organization.
RELEVANT EXPERIENCE
Highly organized, Business-minded self-starter, with the demonstrated ability to use data analytics to enhance operational efficiency across multiple business line, a proven ability to make professional connections with clients, aptitude for challenge, proficiency in Microsoft Office products, and familiarity with healthcare systems. Offering a can-do attitude, sense of urgency and unbeatable work ethic. While managing and helping oversee daily administrative functions.
Overview
6
6
years of professional experience
Work History
Medical Credentialing Coordinator
HNI Healthcare
07.2022 - Current
- Facilitates administrative tasks relating to healthcare practitioners credentialing
- Check, verify the education, licensing, and certification of employees and keep records of their compliance with state or regional regulations
- Recognize and resolve any discrepancies in information and assist healthcare providers with credentialing interrogations
- Work with different departments and credentialing committees to ensure staff members have the necessary accreditations to practice in specified regions, states, or facilities
- Assist with initial credentialing and re-credentialing applications for providers to practice in specified facilities
- Direct and lead weekly meeting sessions with program directors, credentialing specialists and other facility organizers
- Collecting information from the National Practitioner Data Bank (NPDB), the applicant, and their malpractice insurer, and other relevant sources
- Respond to health plan provider inquiries
- Enrolled providers and Medicaid, Medicare and private insurance plans.
- Collected and analyzed information to monitor compliance outcomes and identify and address trends of non-compliant behavior.
- Developed and monitored employee recognition programs.
- Conducted performance reviews and provided feedback to managers on employee performance.
- Advocated for staff members, helping to identify and resolve conflicts.
- Obtained NPI numbers for providers and facilities and updated existing profiles.
- Received and evaluated applications to look for missing and inaccurate information.
- Prepared records for site visits and file audits.
- Conducted primary source verifications such as background checks and board certifications.
Administrative Assistant
University Hospital
11.2017 - 07.2022
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Received and sorted incoming mail and packages to record, dispatch, or distribute to correct recipient.
- Created and maintained databases to track and record customer data.
- Developed and updated spreadsheets and databases to track, analyze, and report on performance and sales data.
- Interacted with vendors, contractors and professional services personnel to receive orders, direct activities, and communicate instructions.
- Volunteered to help with special projects of varying degrees of complexity.
- Opened and properly distributed incoming mail to promote quicker response to client inquiries.
- Restocked supplies and placed purchase orders to maintain adequate stock levels.
- Executed record filing system to improve document organization and management.
- Scheduled office meetings and client appointments for staff teams.
Medical Insurance Representative
Performance Health
05.2017 - 11.2017
- Verified patient insurance coverage and benefits for medical claims.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Followed up on denied claims to verify timely patient payment and resolution.
- Managed large volume of medical claims on daily basis.
- Researched and resolved complex medical claims issues to support timely processing.
- Used administrative guidelines as resource or to answer questions when processing medical claims.
- Identified and resolved discrepancies between patient information and claims data.
- Assessed medical claims for compliance with regulations and corrected discrepancies.
- Responded to correspondence from insurance companies.
- Generated reports on medical claims processing activities and results.
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Monitored and updated claims status in claims processing system.
- Analyzed customer needs to provide customized insurance solutions.
- Met with customers to provide information about available products and policies.
- Analyzed risk factors to recommend appropriate coverage levels.
- Researched and identified potential new markets.
Education
Bachelor of Science - Biology
Kent State University
Kent, OHMBA - Business Administration
Grand Canyon University
Grand Canyon, AZSkills
- Kronos, Qgenda, Athena, Soarian
- Oracle, OnBase, and AMER Payroll
- Project Management
- Budget Planning
- Communication
- Data Analytics
- Problem Resolution
- Provider Relations
- Client Satisfaction
- Business Correspondence
- Active Listening
- Compliance Law
- Microsoft Office
- Provider Enrollment
- Benefits Administration
- Applicant Qualification
Timeline
Medical Credentialing Coordinator
HNI Healthcare
07.2022 - Current
Administrative Assistant
University Hospital
11.2017 - 07.2022
Medical Insurance Representative
Performance Health
05.2017 - 11.2017
Bachelor of Science - Biology
Kent State University
MBA - Business Administration
Grand Canyon University
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