Courtney Pryor
Baltimore,MD
Summary
Detail-oriented Healthcare Administration professional experienced in CMS provider data management and regulatory compliance. Expertise in provider enrollment, data analysis, and maintaining HIPAA standards. Conducts quality assurance reviews and monitors enrollment activities to ensure compliance and data integrity. Committed to maintaining accurate, audit-ready documentation in fast-paced healthcare settings.
Overview
6
6
years of post-secondary education
9
9
years of professional experience
Work History
Compliance Analyst II
CoventBridge
Ohio City, Ohio
09.2025 - Current
- Conducted audits to ensure adherence to compliance standards for fraud, waste, and abuse.
- Collaborated with cross-functional teams to perform risk assessments, enhancing overall compliance strategy.
- Reviewed CMS regulatory compliance policies for healthcare operations.
- Developed corrective action plans after identifying non-compliance issues.
Document Processor II
Reli Group
Woodlawn, USA
01.2022 - 09.2025
- Processed incoming documents for accurate data entry and compliance.
- Proofread documents to ensure quality control prior to processing, contributing to error-free documentation.
- Reviewed and categorized complaints related to fraud according to federal guidelines. according to the federal client's operating & internal procedures for CMS
- Collaborated with team members on complex projects to manage large volumes of documents, enhancing project workflow.
- Assisted with the development of new processes to improve efficiency.
- Prepared reports summarizing document activity as requested.
Staffing Coordinator
Genesis HealthCare
Baltimore, USA
05.2020 - 04.2021
- Scheduled employee shifts nationwide for Genesis nursing homes, ensuring adequate staffing across all locations.
- Schedule employee shifts nationwide for all Genesis Nursing homes
- Managed employee data in HRIS, maintaining accuracy and compliance for effective staffing decisions.
- Audited employee shifts for accuracy, ensuring proper staffing levels at each location.
- Coordinated work shift schedules based on employee availability, optimizing coverage and minimizing scheduling conflicts.
Pharmacy Program Coordinator
Option Care
Baltimore, USA
10.2017 - 12.2019
- Executed data entry and provided customer support to enhance patient experience
- Reviewing and Providing Clinical Information to Payers
- Submitting authorizations and re-authorizations
- Verified benefits and eligibility with patients' insurance plans nationwide to facilitate access to necessary treatments
- Ensured smooth collaboration with physicians' offices to manage and expedite appeal processes.
- Quoting of financial responsibilities to patients and enrolling them in co-pay assistance programs
- Coordinated home infusion services for patients in their residences, ensuring timely delivery and administration.
- Enrolled patients in co-pay assistance programs after quoting their financial responsibilities.
- Coordinated with physicians' offices to manage appeal processes for insurance coverage
Education
Certificate - Pharmacy
Penn Foster
Scranton, PA 01.2009 - 01.2011
High School Diploma - Business
Carver Vocational Technical
Baltimore , Md 09.2002 - 06.2006
Skills
- Regulatory compliance
- Compliance auditing
- Risk assessment
- Fraud investigation
- Document review
- Quality control
- Data analysis
- Billing and coding
- Medical terminology
- Action planning
- Problem solving
- Attention to detail
- Client relations
Timeline
Compliance Analyst II
CoventBridge
09.2025 - Current
Document Processor II
Reli Group
01.2022 - 09.2025
Staffing Coordinator
Genesis HealthCare
05.2020 - 04.2021
Pharmacy Program Coordinator
Option Care
10.2017 - 12.2019
Certificate - Pharmacy
Penn Foster
01.2009 - 01.2011
High School Diploma - Business
Carver Vocational Technical
09.2002 - 06.2006