Summary
Overview
Work History
Education
Skills
Timeline
Generic

Donetta Burris

Oklahoma City

Summary

Results-driven Provider Services Representative capable of completing tasks with high productivity and efficiency. Specialize in communication, problem-solving, and data management skills which are crucial for navigating complex provider networks and ensuring service excellence. Excel in teamwork, adaptability, and customer service, leveraging these soft skills to enhance interactions with providers and support organizational objectives.

Overview

11
11
years of professional experience
20
20
years of post-secondary education

Work History

Provider Services Representative III

Oklahoma Healthcare Authority
Oklahoma City
10.2021 - 03.2026
  • Research and Resolve Legal Appeals
  • Educated providers on policy changes and program benefits through informational sessions.
  • Oversee call volume and representative availability
  • Review documentation on claims reconsideration to determine if we can pay

Provider Services Representative II

Oklahoma Healthcare Authority
Oklahoma City
10.2019 - 10.2021
  • Educating providers on OHCA’s billing guidelines and policy.
  • Assisting with claims issues and how to process claims correctly.
  • Special process provider claims that are sent in for reconsideration.

Eligibility Specialist

Maximus Inc
Oklahoma City
04.2019 - 10.2019
  • Assist and educate members on eligibility requirements
  • Calculate paystubs to determine eligibility for members under the Federal guidelines.
  • Process incoming documents and update member applications to match the documents

Provider Services Representative

Maximus Inc
Oklahoma City
02.2015 - 04.2019
  • Research claims for members and providers
  • Advise of errors on denied claims and assist in correcting
  • Keep up to date on all SoonerCare policies and procedures
  • Assist providers with warrant information
  • Also mentoring new representatives with their transition from the training room to taking calls on their own

Education

Medical Secretary

Francis Tuttle
OKLAHOMA CITY, Ok
01.2006 - 06.2026

GED
OKLAHOMA CITY, Ok

Skills

  • Medical terminology
  • Office administration
  • Customer service
  • Claim processing
  • MS Excel PowerPoint
  • Customer service
  • Microsoft Office

Timeline

Provider Services Representative III

Oklahoma Healthcare Authority
10.2021 - 03.2026

Provider Services Representative II

Oklahoma Healthcare Authority
10.2019 - 10.2021

Eligibility Specialist

Maximus Inc
04.2019 - 10.2019

Provider Services Representative

Maximus Inc
02.2015 - 04.2019

Medical Secretary

Francis Tuttle
01.2006 - 06.2026

GED
Donetta Burris