DeQuariyez Anderson
Atlanta,GA
Summary
Strategic operations professional with over 8 years of experience enhancing customer satisfaction and streamlining service workflows. Leader with 3 years of management in customer service operations, focused on driving performance and process improvement. Currently pursuing a CAHIIM-accredited B.S. in Health Information Management, equipped with analytical and communication skills to excel in customer-focused environments.
Overview
1
1
Certification
11
11
years of professional experience
Work History
Provider Relations Specialist
Gainwell Technologies LLC
Tallahassee, FL
10.2025 - Current
- Coordinated stakeholder communication workflows for Florida Medicaid Health Plans, providers, and internal teams, ensuring timely, accurate information flow and effective issue resolution.
- Provided stakeholder communication workflows by coordinating inquiries and issue resolution across Florida Medicaid Health Plans, providers, and internal teams, ensuring timely and accurate information flow throughout the program.
- Managed communication for claim denials and EOB issues, identified trends, escalated systemic problems, and contributed to reduction in denial rates, enhancing stakeholder revenue.
- Documented recurring issues for process improvement initiatives, recommended workflow enhancements, and aligned solutions with organizational goals and Medicaid program requirements.
- Communicated X12 encounter standards, professional, and institutional reimbursement methodologies to stakeholders while proactively mitigating adjudication errors to ensure accurate and compliant claim outcomes.
- Provided critical operational support by temporarily staffing call center operations during contract negotiations, ensuring uninterrupted service delivery and contributing to significant cost savings for the organization.
Provider Enrollment and Services Team lead
Gainwell Technologies LLC
Tallahassee, FL
04.2022 - 10.2025
- Supported cross-functional issue resolution by guiding less-experienced representatives through complex Provider Enrollment and Provider Services inquiries, improving workflow efficiency across both contact centers.
- Supported daily operational management by training staff, monitoring performance, and coordinating workflows to enhance team effectiveness.
- Identified performance gaps and provided coaching recommendations or escalation for corrective action or termination when necessary.
- Identified performance gaps and recommended coaching or escalated cases for corrective action or termination.
- Managed attendance and adherence reporting to meet monthly Client SLAs and KPIs, ensuring timely submission and data accuracy.
- Managed attendance and adherence reporting to fulfill monthly client SLAs and KPIs, ensuring timely submissions and accurate data.
- Contributed to achieving monthly operational goals, including 90% adherence across both contact centers.
- Developed and delivered monthly training huddles via PowerPoint and Teams to reinforce policy updates and operational best practices.
Provider Enrollment Escalation Specialist
Gainwell Technologies LLC
Tallahassee, FL
10.2020 - 04.2022
- Reviewed and validated provider application documents submitted through the Medicaid Management System to ensure accurate processing and reprocessing within established timelines.
- Reviewed and validated provider application documents in Medicaid Management System to ensure accurate and timely processing.
- Supported less-experienced team members by guiding them through complex customer and provider inquiries, improving overall issue resolution efficiency across the service center.
- Maintained and updated Excel tracking sheets for provider systems and operational data fixes, enhancing data accuracy and workflow transparency.
- Managed team emails, department updates, and Medicaid Fiscal Area Office correspondence, ensuring consistent information flow across the team.
- Scheduled team huddles and meetings to support coordination, alignment, and ongoing operational updates.
- Handled phone inquiries to ensure uninterrupted service during staffing gaps.
Provider Enrollment Associate
DXC Technology
Tallahassee, FL
05.2018 - 10.2020
- Handled 30–40 inbound inquiries daily for high-volume provider operations, providing accurate guidance on enrollment applications to ensure service continuity.
- Verified submitted documentation through quality-control review, preventing miscommunication and minimizing clerical errors.
- Guided providers through Medicaid enrollment procedures with professionalism, reinforcing adherence to processes and clarifying expectations.
- Analyzed and communicated deficiencies across hundreds of documents daily, contributing to improved accuracy, compliance, and workflow efficiency.
Team Lead Coach
Conduent
Tallahassee, FL
02.2017 - 05.2018
- Assisted close to 20 agents with daily calls, de-escalations for at-risk surveys, coaching the agents to meet their daily goals, as well as assisting the supervisors with agent evaluations.
- Handled 40-60 customer calls daily, addressing inquiries and resolving issues effectively.
- Achieved team lead status to enhance team performance.
- Supported supervisors by evaluating agent performance and guiding agents to achieve daily goals.
Marketing Sales Associate
California Marketing Group
Tallahassee, FL
01.2017 - 02.2017
- Handled 50 inbound calls daily to meet magazine sales quota and ensure positive customer experience
- Focused on attracting medical professionals, entrepreneurs, and social businesses to maintain magazine subscriptions
- Maintained 90% acceptance rate of subscriptions to fulfill business needs
Customer Service Rep
Event Photography Group
Tallahassee, FL
04.2016 - 01.2017
- Achieved sales and tech support goals by exceeding quotas through effective site navigation and customer engagement
- Fulfilled customer orders accurately
- Handled customer inquiries via email and live chat, providing prompt and accurate support to enhance customer experience.
Lead Server
Summit Medical Group, P.L.L.C.
Venice, FL
07.2015 - 08.2016
- Ensured accurate settlement of customer checks to maintain financial integrity
- Handled cash transactions and maintained cleanliness of work area
- Assisted guests by serving food and seating them in a welcoming manner
- Settle out checks
Education
High school Diploma -
North Port High school
01-2014
B.S. - Health Information Management
University of Arizona Global Campus
09-2026
Skills
- Claims management
- Customer service management
- Medicaid program oversight
- X12 transaction analysis
- Healthcare provider relations
- EHR system management
- Medical Terminology
- Nuance Clintegity 360
- Proficient in Solventum CRS applications
- HIPAA Compliance
- Microsoft Excel
- Operational Management
- SLA management
- Process Improvement
- Project Coordination
- Operational Training
- Cross-Functional Collaboration
- Member enrollment
- Health plan operations
Certification
Candidate, Project Management Institute (PMI), Candidate, Certified Associate Project Manager (CAPM) -In Progress
Timeline
Provider Relations Specialist
Gainwell Technologies LLC
10.2025 - Current
Provider Enrollment and Services Team lead
Gainwell Technologies LLC
04.2022 - 10.2025
Provider Enrollment Escalation Specialist
Gainwell Technologies LLC
10.2020 - 04.2022
Provider Enrollment Associate
DXC Technology
05.2018 - 10.2020
Team Lead Coach
Conduent
02.2017 - 05.2018
Marketing Sales Associate
California Marketing Group
01.2017 - 02.2017
Customer Service Rep
Event Photography Group
04.2016 - 01.2017
Lead Server
Summit Medical Group, P.L.L.C.
07.2015 - 08.2016
B.S. - Health Information Management
University of Arizona Global Campus
High school Diploma -
North Port High school