Joseph williams
Redlands,CA
Summary
Knowledgeable Provider Relations Representative offering more than 2 years of experience in field. Successfully optimizes services, resolves billing inquiries and reviews data quality.
Overview
8
8
years of professional experience
Work History
Provider Relations Representative
Inland Empire Health Plan
01.2023 - 05.2024
- Maintained professional relationships with healthcare providers
- Handled more than 50 calls each day with consistently high satisfaction ratings from callers
- Served as a liaison between healthcare organizations and insurance companies to ensure seamless communication regarding claims processing and payment matters.
- Assisted providers in navigating through various reimbursement processes, resulting in timely payments and reduced financial disputes between parties.
Provider Relations Representative
United Health Share Ministries
05.2022 - 11.2022
- Maintained professional relationships with healthcare providers
- Investigated concerns such as billing and claims questions on behalf of providers
- Reviewed complex and unusual claims to determine coverage restrictions
- Stayed current on available policies and plans
- Handled more than 60 calls each day with consistent high satisfaction ratings from callers
Records Retrieval Specialist
ABI Documents
07.2021 - 05.2022
- Performed basic administrative duties by answering calls, taking messages, data entry, typing tasks, and locating files upon request
- Assisted in the implementation of digital recordkeeping systems, contributing to a more streamlined retrieval process.
- Reduced processing time for record requests through proactive anticipation of client needs based on historical trends.
Insurance Specialist
Automobile Club Of Southern California
06.2019 - 08.2020
- Counseled policyholders on vehicle coverages, Annual premium billing, updating drivers, miles, all vehicle modifications/changes
- 40-50 Inbound calls daily
- Renew annual memberships, and Upgraded memberships
Medical Records Specialist
Advantmed
02.2016 - 05.2019
- Maintained accurate documentation of all activities related to medical records.
- Collaborated with multiple departments to coordinate the release of information requests from patients, legal representatives, and insurance companies.
- Ensured that all required forms were completed accurately and completely prior to storage or release.
- Adhered to HIPAA guidelines when handling protected health information.
- Performed data entry into electronic health record systems.
Education
Associate of Science - Information Technology
Chaffey College
Rancho Cucamonga, CA06-2026
Technical Diploma -
UEI College
Ontario, CA12.2008
GED -
San Bernardino Adult School
San Bernardino, CA06.2008
Skills
- Customer Service
- Problem-Solving
- Communication
- Attention to Detail
- Time Management
- Critical Thinking
- Interpersonal Skills
- Conflict Resolution
Timeline
Provider Relations Representative
Inland Empire Health Plan
01.2023 - 05.2024
Provider Relations Representative
United Health Share Ministries
05.2022 - 11.2022
Records Retrieval Specialist
ABI Documents
07.2021 - 05.2022
Insurance Specialist
Automobile Club Of Southern California
06.2019 - 08.2020
Medical Records Specialist
Advantmed
02.2016 - 05.2019
Technical Diploma -
UEI College
GED -
San Bernardino Adult School
Associate of Science - Information Technology
Chaffey College
Similar Profiles
DARLENE MORALESDARLENE MORALES
Provider Call Center Representative at Inland Empire Health PlanProvider Call Center Representative at Inland Empire Health Plan
GISELL CHAVEZAMESGISELL CHAVEZAMES
Provider Call Center Senior at Inland Empire Health PlanProvider Call Center Senior at Inland Empire Health Plan
Justin Womer, LCSW, LAADACJustin Womer, LCSW, LAADAC
Behavioral Health Care Manager at Inland Empire Health PlanBehavioral Health Care Manager at Inland Empire Health Plan