Summary
Overview
Work History
Education
Skills
Timeline
Generic

Deonya Ferree

Whitsett,NC

Summary

15+ years experience in healthcare administration with an expansive knowledge of medical terminology. Exceedingly well organized, flexible, and genuinely enjoys challenges of supporting a large office. Client focused, service driven, superior work ethic, and solid integrity. Self motivated ability to take risks and accept responsibility, strong decision making skills. Quickly identify gaps in processes and effectively problem solves to drive results. Excellent multi-tasking and prioritization skills through successful management of multiple simultaneous projects. Excellent interpersonal skills and proven ability to work independently or in a team environment. Proven ability to quickly build rapport with all levels of management. Pay close attention to detail in order to execute properly. Resilient, versatile, and accustomed to working in a fast paced environment(s). Advanced knowledge in MS Office Programs, Windows 7, Mac O/S, ETS, Vista, PVOS, NDB, UNET, Phycon, Omega, IBAAG, Qfiniti & CSP Facets, Salesforce, OHBS Facets

Overview

17
17
years of professional experience

Work History

Provider Data Analyst

United HealthCare (UHC)
06.2023 - Current
  • Investigate &resolve demographic and contractual requests from end to end problem remediation.
  • Review, Evaluate and update appropriate platforms for provider demographic changes to maintain accuracy of data in NDB.
  • Verify secondary systems to ensure accurate system feeds
  • Participate in applicable ad hoc projects
  • Maintain current knowledge of business strategies, rules, and procedures.

Credentialing Representative

United Behavioral Health (UBH)
10.2021 - 06.2023
  • Conducts primary source verifications NPI, OIG, SAM, Opt Out, NPDB
  • Research and evaluate applications to look for missing and inaccurate information
  • Conduct audits and provide feedback to reduce errors and improve processes and performance
  • Contact providers or representatives by telephone or in writing to obtain additional information while processing enrollment applications
  • Ability to problem solve issues through reviewing provider files and ensuring compliance is met before submitting to QA.

Provider Data Specialist

United HealthCare (UHC)
01.2018 - 10.2021
  • Maintaining provider directory information via call, fax, email
  • Review Report, Review and Analyze provider demographic data using appropriate systems and tools
  • Identify root causes of provider data issues and utilize appropriate stakeholders to monitor and maintain date integrity
  • Conducts audits and provides feedback to reduce errors and ensure integrity of database
  • Communicates with other departments to improve processes and quality assurance
  • May be responsible for representing team or department in various company projects and testing.

Legal Custodian of Record

United HealthCare (UHC)
03.2010 - 01.2018
  • Maintain compliant disclosure for various UHC products and services
  • Responsible for all recordkeeping agreements and other platform arrangements
  • Work with external and internal sources to launch UHC new products and services
  • Research any outstanding issues related to securities, HIPPA, and insurance laws.

Claims/Issue Resolution Unit (IRU) Processor

United HealthCare (UHC)
03.2007 - 03.2010
  • Researched, investigated, and processed all incoming UHC claims in accordance to plan design
  • Validated information on all medical claims received to ensure no missing or incomplete information
  • Authorized appropriate payment or refers claims to investigators for further review
  • Analyzed and identified trends and provided reports to management
  • Recognized claims by determining claim type - HCFA, Hospital, UB, and/or RX
  • Identified more complicated claims and referred them to Senior Claim Processor or Supervisor
  • Worked claims files to ensure the appropriate eligibility and claim matching
  • Maintained and managed all claim inventories in accordance with health plan and regulatory policies
  • Partnered management to identify processing errors and/or training-related opportunities to improve operation results.

Education

Johnson C Smith University
Charlotte, NC

Skills

  • HIPAA Compliance
  • Healthcare Industry Knowledge

Timeline

Provider Data Analyst

United HealthCare (UHC)
06.2023 - Current

Credentialing Representative

United Behavioral Health (UBH)
10.2021 - 06.2023

Provider Data Specialist

United HealthCare (UHC)
01.2018 - 10.2021

Legal Custodian of Record

United HealthCare (UHC)
03.2010 - 01.2018

Claims/Issue Resolution Unit (IRU) Processor

United HealthCare (UHC)
03.2007 - 03.2010

Johnson C Smith University
Deonya Ferree