Briana Burgher
Summary
Experienced with managing provider enrollment processes, ensuring timely and accurate credentialing. Utilizes strong communication and organizational skills to enhance workflow efficiency. Knowledge of compliance regulations and documentation management ensures seamless operations.
Overview
6
6
years of professional experience
Work History
Provider Enrollment Specialist
Gainwell Technologies
08.2024 - 05.2025
- Managed provider enrollment processes to ensure compliance with regulatory requirements.
- Coordinated communication between healthcare providers and insurance companies to streamline enrollment procedures.
- Developed training materials for new staff on enrollment software and best practices.
- Reviewed and verified provider applications to maintain accuracy and completeness of data.
- Prepared and processed provider enrollments with Medicare and Medicaid in multiple states.
Provider Enrollment Specialist
TDB COMMUNICATIONS
02.2022 - 08.2024
- Processed applications for new providers, verifying their credentials and licensure information.
- Collaborated with other departments to ensure timely completion of enrollments and revalidation's.
- Coordinated with state agencies to resolve any questions or disputes pertaining to provider credentials.
- Analyzed enrollment forms for completeness and accuracy before submitting them for processing.
- PECOS was used to verify the provider's information
- Assisted providers with navigating online portal systems, enhancing user experience and expediting application submissions.
Health Benefits Coordinator
Conduent
11.2020 - 01.2022
- Planned, organized and managed open enrollment meetings to educate employees on available health benefit options.
- Responded promptly to any complaints or grievances filed by employees regarding their healthcare coverage.
- Developed training materials used by HR staff members responsible for administering health benefits programs.
- Utilized customer service skills to respond to employee inquiries about their health benefits coverage.
- Implemented best practices regarding HIPAA privacy rules when handling confidential medical information.
- Maintained confidentiality of all employee information.
Sales Associate
Victoria's Secret
10.2019 - 01.2021
- Greeted customers warmly and offered assistance.
- Helped customers find and select products.
- Kept work area clean, organized and free of clutter at all times.
- Operated cash register and POS to handle purchases, refunds, and exchanges for customers.
- Demonstrated exceptional customer service skills, resolving customer complaints efficiently and courteously.
- Provided accurate information about products, prices and availability both in person and over the phone.
Cashier
ShopRite
12.2018 - 12.2019
- Operated cash register and accurately processed payments, returns, and exchanges.
- Maintained cleanliness of the checkout area by cleaning counters, shelves and windows.
- Performed opening and closing procedures, such as counting cash register, restocking, and cleaning.
- Built and maintained positive working relationships with co-workers.
- Helped restock shelves when necessary to maintain an organized display area.
- Accurately processed customer payments using cash, credit cards, and checks.
- Managed large amounts of cash accurately during busy hours in a fast-paced environment.
- Provided efficient and courteous service to customers.
Education
Cosmetology Business -
Empire
5 2019
High School Diploma - undefined
Pemberton Twp High School
6 2018
Skills
- Software Proficiency
- Cross-Functional Collaboration
- Multitasking Capabilities
- Interpersonal Skills
- Provider Enrollment Expertise
- HIPAA Compliance Awareness
- Data Entry Proficiency
- Effective written and verbal communication
- Medical terminology
Timeline
Provider Enrollment Specialist
Gainwell Technologies
08.2024 - 05.2025
Provider Enrollment Specialist
TDB COMMUNICATIONS
02.2022 - 08.2024
Health Benefits Coordinator
Conduent
11.2020 - 01.2022
Sales Associate
Victoria's Secret
10.2019 - 01.2021
Cashier
ShopRite
12.2018 - 12.2019
High School Diploma - undefined
Pemberton Twp High School
Cosmetology Business -
Empire
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