Elizabeth Medina
Austin,US
Summary
Professional with in-depth experience in healthcare operations and provider enrollment. Skilled in navigating complex regulatory requirements, ensuring compliance, and streamlining processes for efficiency. Strong focus on team collaboration and achieving results, adaptable to changing needs. Known for exceptional organizational skills, problem-solving abilities, and effective communication.
Overview
18
18
years of professional experience
Work History
Provider Enrollment Specialist
Texas Medicaid and Health Partnership/Collabera
09.2018 - Current
- Proficient in On Base & Phoenix System functionality
- File Maintenance updates post enrollment for Medicaid Providers (address, licenses, certifications, etc.)
- Experienced and proficient in high volume transactions in a fast paced environment
- Maintains strict confidentiality of information and files per HIPAA requirements
- Correspondence to providers to ensure deficiencies are communicated effectively to request corrections
- Follows extensive instructions through WIKI for all continuity and consistency
- Champion for Quality assurance of work executed.
Client Account Support Associate
Cigna Supplemental Benefits/ Randstad
Austin, US
06.2017 - 08.2018
- Proficient in On Base
- Process agent's contracts
- Licensing issues
- Updated demographics information in LifePro.
Claims Processor/Account Resolution Representative
Little River Healthcare/Aerotek
Round Rock, US
02.2017 - 05.2017
- Process claims
- Verify claim status for payments posting
- Billing and coding.
Enrollment Processor/ Coordinator of Benefits Specialist
FirstCare Health Plans
Austin, US
11.2014 - 01.2017
- Assisted customers with order placement
- Maintained contact with new and existing clients as instructed
- Prepared letters, documents, spreadsheets, and reports
- Coordination of Benefits for Commercial, Medicaid, Medicare.
- Credentialing
Administrator I
Maximus
Austin, US
12.2007 - 11.2014
- Prepared correspondence and other government forms
- Received/reviewed incoming documents to determine distribution
- Processed documents, memos and reports
- Prepared letters, documents, spreadsheets, and reports
- Assisted customers with order placement
- Adhered to all company policies, standards and technical procedures for preserving the security of data
- Filing and documentation
- Ensure proper implementation of council policies and procedures
- Supervised 5 document clerks
- Ensured compliance with deadlines by creating work-flow charts and diagrams for the team.
Education
Bachelor of Science - Accounting
University of Phoenix
Phoenix, AZ, US12.2026
High School Diploma - US
Lanier High School
TX01.2005
Skills
- Data entry proficiency
- Knowledgeable in Kronos,XIFIN/Cerner, PEMS, EPIC, Onbase, AWS, Phoenix, HealthEdge
- Credentialing
- Validation of discrepancies
- Provider enrollment expertise
- Insurance verification experience
- Strong organization
- Exceptional communication
- Mathematics skills
- Application verification
- Documentation management
- Record maintenance
- Telephone and email skills
- Teamwork and collaboration
- Innovation and creativity
- Problem-solving
- Time management
- Computer proficiency
- Healthcare
Languages
English
Spanish
French
Timeline
Provider Enrollment Specialist
Texas Medicaid and Health Partnership/Collabera
09.2018 - Current
Client Account Support Associate
Cigna Supplemental Benefits/ Randstad
06.2017 - 08.2018
Claims Processor/Account Resolution Representative
Little River Healthcare/Aerotek
02.2017 - 05.2017
Enrollment Processor/ Coordinator of Benefits Specialist
FirstCare Health Plans
11.2014 - 01.2017
Administrator I
Maximus
12.2007 - 11.2014
High School Diploma - US
Lanier High School
Bachelor of Science - Accounting
University of Phoenix