Summary
Overview
Work History
Education
Skills
Timeline
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Britney Daniels

Florissant,MO

Summary

Versatile Provider Service Advocate committed to maintaining high customer satisfaction by providing friendly, fast service for all needs. Skillful in researching and resolving billing discrepancies and claims. Disciplined and energetic professional well-versed in medical claim appeal processing, clinical relations and medical billing. Possessing in-depth knowledge of various insurance plans and policies. Communicative and detail-oriented individual with excellent interpersonal abilities.

Overview

16
16
years of professional experience

Work History

PROVIDER RELATIONS ADVOCATE SR

UNITED HEALTH GROUP
04.2016 - Current
  • Adhered to company policies and scripts to consistently achieve call-time and quality standards, also meeting company metrics consistently.
  • Thoroughly review, analyze, and research complex health care claims to identify discrepancies, verify pricing, confirm prior authorizations, and process them for payment.
  • Streamlined communication channels through implementation of centralized contact system for providers and internal teams.
  • Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
  • Demonstrated adaptability through cross-training in various roles within pharmacy setting to better serve customers as needed.
  • Developed comprehensive understanding of ICD-10-CM, CPT, and HCPCS codes to ensure proper use in medical coding assignments.
  • Reduced claim denial rates with thorough pre-appeal reviews, identifying potential issues before submission.
  • Trained team members on new hotel services and products to support promotional efforts.
  • Strengthened customer loyalty by providing excellent service during interactions with both internal teams and external partners such as insurance carriers or other healthcare organizations.

GENERAL MANAGER

TMX FINANCE
06.2010 - 04.2016
  • Enhanced customer satisfaction with proactive communication, timely issue resolution, and continuous process improvement initiatives.
  • Trained and guided team members to maintain high productivity and performance metrics.
  • Implemented business strategies, increasing revenue, and effectively targeting new markets.
  • Reduced financial inconsistencies while assessing and verifying billing invoices and expense reports.
  • Organized promotional events and interacted with community to increase sales volume.
  • Increased profit margins by effectively controlling budget and overhead and optimizing product turns.

BRANCH MANAGER

ACE CASH EXPRESS
01.2008 - 05.2010
  • Continuously monitored branch performance against key performance indicators, taking actions as needed to ensure objectives were met or exceeded.
  • Oversaw daily operations for streamlined efficiency, ensuring timely execution of tasks and optimal resource allocation.
  • Evaluated employee performance regularly through appraisals and feedback sessions to facilitate continuous development of skills and knowledge base within the team.
  • Strengthened relationships with key clients, securing long-term partnerships and driving revenue growth.
  • Increased branch profitability by implementing cost-saving measures and streamlining operational processes.

Education

High School Diploma -

Smart Horizons
Pompano Beach, FL

Smart Horizons
Pompano Beach, FL

School of Continuing & Professional Studies At Washington University
St. Louis, MO
12.2023

Skills

  • Insurance Regulations Understanding
  • Healthcare Industry Knowledge
  • Policy Interpretation
  • Provider network management
  • Provider support
  • Health plan operations
  • Strategic Business Relationships
  • Project Management
  • Dispute Resolution
  • Exceptional written and vocal communicator
  • Punctual time manager and organizer
  • Highly critical thinker with fact- based decision-making abilities

Timeline

PROVIDER RELATIONS ADVOCATE SR

UNITED HEALTH GROUP
04.2016 - Current

GENERAL MANAGER

TMX FINANCE
06.2010 - 04.2016

BRANCH MANAGER

ACE CASH EXPRESS
01.2008 - 05.2010

High School Diploma -

Smart Horizons

Smart Horizons

School of Continuing & Professional Studies At Washington University

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Britney Daniels