Cheri Brown

• Answered provider inquiries for Tier 1/Tier 2 Medicare Advantage provider groups via email, telephone and written correspondence for the Midwest/Mid America region (Kansas City, Illinois, St. Louis).
• Fostered strong, positive relationships with key providers by coordinating, facilitating and leading partnership meetings and identifying on-site enrollment opportunities.
• Contributed to and enhanced audit processes to maximize quality management standards.
• Initiated physician and hospital orientations to support ongoing education of health care provider community.
• Researched and resolved disputes, billing discrepancies, and claims efficiently to maintain customer satisfaction.
• Identified opportunities for process improvement within the provider relations department, implementing changes that led to increased efficiency and cost savings.

• Supports an intake process to review and resolve provider inquiries for an aligned market(s) includes research, root cause, resolution and/or triage to appropriate team in timely manner
• Accountable to servicing the provider to include face to face education, root cause analysis, and resolution.
• Initiates and maintains effective channels of communication with internal matrix partners.
• Manage regulatory and escalated matters to defined service level agreements
• Effectively engage in face-to-face, virtual, and written communication
• Collaborate internally to share provider feedback and assist with strategies to help mitigate downward trends and expand momentum on positive trends
• Educate providers on Cigna's business objectives, standard operating procedures, policies, and programs available through tools such as Cigna Network Newsletter, vendor updates, coverage policies and digital solutions
• Participates, collaborates, and supports strategic projects as determined by Medicare Provider Relations Operations Manager
• Serves as a provider advocate both internally and externally
• Participate in market and team meetings to share findings.
• Monitors and tracks all service issues and inquiries in the appropriate tools.
• Responsible for meeting internal metrics around service goals
• Other duties as assigned

• Assisted in researching and resolving provider claim issues.
• Submitting provider change requests in a timely manner to update provider demographics, credentialing, and contract changes.
• Completed provider kit deliveries for the Clay/Duval County Market.
• Managing the Central Florida Mailbox.
• Maintaining positive relationships with providers and group contacts to prevent provider abrasion.
• Tracking and updating designated trackers thru Microsoft Excel.

• Provided information for Medicare Advantage plans such as copay, approval procedures and available products.
• Developed and implemented training classes to educate team members.
• Maintained full and current understanding of available plans, products and services.
• Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity.
• Proficient in claims task such as adjustments, data entry and held claims.
• Participated in CMS audit process.
• Participated in team projects, demonstrating an ability to work collaboratively and effectively