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
Maryland Heights, Missouri
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
Saint Louis, MO
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
Saint Louis, Missouri
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, FLSmart Horizons
Pompano Beach, FLSchool of Continuing & Professional Studies At Washington University
St. Louis, MO12.2023
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