Summary
Overview
Work History
Education
Skills
Affiliations
Certification
Additional Information
Timeline
Generic

Deanna Mora-Duarte

PALMDALE,CA

Summary

Organized administrative management with 10 years of experience in Provider Credentialing. Committed to providing individualized, comprehensive and detailed oriented services. Adept at initiating, completing, negotiating and delivering contracts. Prioritize projects and multitask effectively to achieve project goals. Methodical and detail-oriented team player with expertise in team leadership. Offering these skills and strong work ethic.

Overview

17
17
years of professional experience
1
1
Certification

Work History

Provider Service Specialist/Office Manager

Cara Medical Billing
Lancaster, CA
10.2007 - Current
  • Initiate credentialing and contracting for all physicians and clinicians.
  • Review contracts for fee for service and capitation for providers to accept delegated rates.
  • Liaise and network with facilities for providers to complete supporting documentation for credentialing and contracting.
  • Completed re-validations and appointments for contracted facilities.
  • Proficient in provider data bases: NPPES, PECOS, PAVE, Breeze, NPDB, GSA, OIG and CAQH.
  • Maintain and update all provider files and update as needed.
  • Facilitate billing and coding process for all providers, mapping for EDI, EFT, and access to all provider portals.
  • Process Medical billing to submit claims to insurance companies: PPO, EPO, HMO, IPA's, Cobra, HSA, Medicare, Medicaid, Workers Compensation, Disability Insurance and Personal Injury.
  • Assign ICD-10 and CPT coding for billing to insurance companies for claims processing.
  • Receive and settle all escalated calls that arise.

Lead Customer Service Representative

Countrywide Home Loans
Lancaster, CA
02.2004 - 11.2006
  • Trained, oversaw and mentored new team members to strengthen performance and job expertise.
  • Planned schedules and workflows based on expected customer demands.
  • Met customer call guidelines for service levels, handle time and productivity.
  • Promoted superior experience by addressing customer concerns, demonstrating empathy and resolving problems swiftly.
  • Cross-trained and provided back up for customer service managers.

Education

Bachelor of Science - Healthcare Administration

Western Governors University
Salt Lake City, UT
10.2024

High School Diploma -

Highland High School
Palmdale, CA
06.1997

Skills

  • Complex Problem-Solving
  • Conflict Resolution Techniques
  • Medical Records Management
  • Electronic Medical Record
  • Recordkeeping Software
  • Professional Relationships
  • Time Management
  • Customer and Personal Service
  • Organization and Time Management skills

Affiliations

The National Society of Leadership and Success

Certification

WGU Microcredential in Business Essentials

Additional Information

Coach Administrator for Palmdale AYSO

Timeline

Provider Service Specialist/Office Manager

Cara Medical Billing
10.2007 - Current

Lead Customer Service Representative

Countrywide Home Loans
02.2004 - 11.2006

Bachelor of Science - Healthcare Administration

Western Governors University

High School Diploma -

Highland High School

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Deanna Mora-Duarte