Gwen Seeley
Catskill,NY
Summary
Dynamic professional with a proven track record at Optum, excelling in roles that demand strong attention to detail and exceptional teamwork. Achieved over 98% data integrity, showcasing adaptability and a robust work ethic. Expert in data entry and fostering collaboration, I consistently enhance operational efficiency and data accuracy.
Overview
27
27
years of professional experience
Work History
Associate Provider Installation Specialist
Optum
10.2020 - Current
- Coordinated with Network Development Public Sector when onboarding Medicaid providers in the states of NC, MS, IN, and OH. Verified provider Medicaid ID's and contracted groups based on state guidelines.
- Coordinated with credentialing, Network Development, and providers to ensure the network demographics and contracts are current and accurate in the ACCENT - NMDB database.
- Maintained data integrity within Accent - NMDB and ensured 98% and above quality per PDM standards.
- Loaded and maintained provider data, executed contracts and health plans into ACCENT - NMDB.
- Created and maintained several job aids.
- Cross trained in other work ques and functions to guarantee improvement of my knowledge, skills, and abilities to help the PDM team.
- Trained multiple team members on PDM process.
Data Analyst
Optum
10.2016 - 09.2020
- Completed audits for CM's by gathering provider information found in various systems.
- Completed requests received by Optum providers regarding their contracts and fee schedules.
- Verified accuracy of data entered into system to produce error-free reports.
- Prioritized tasks effectively to ensure timely completion of all assigned projects without sacrificing attention to detail.
- Reduced turnaround time for projects by consistently meeting or exceeding deadlines while maintaining high-quality work output.
Data Entry Clerk Non-Keyables
Optum
01.2008 - 09.2016
- Sorted documents received through database and directed to the correct department to process.
- Maintained strict confidentiality of sensitive client information, ensuring compliance with industry regulations and company policies.
- Maintained a high level of accuracy and speed through continuous self-assessment.
- Followed established procedures to enter and process data correctly.
- Made out going calls to providers to educate how to use www.myoptumhealthphysicalhealth.com online system.
Claims Processor
Optum
01.2001 - 12.2007
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Managed workload and priorities to meet claims processing meet deadlines.
- Evaluated accuracy and quality of data entered into system.
Member Provider Services Rep
ACN - American Chiropractic Network
Minneapolis, MN
04.1997 - 12.2000
- Streamlined operations by managing a high volume of incoming calls for medical providers seeking information or assistance.
- Coordinated with internal departments on behalf of providers to ensure timely payment resolution for claims disputes or other financial matters.
- Enhanced customer satisfaction by efficiently resolving provider inquiries and concerns.
- Educated providers on billing procedures, coding guidelines, and reimbursement policies for optimal claim submissions.
- Assisted in the training of new Provider Services Representatives, ensuring consistent quality service delivery.
Education
Associate of Arts - Fashion Merchandising
Patricia Stevens Career College
Milwaukee, WI03.1988
Skills
- Strong Work Ethic
- Teamwork and Collaboration
- Customer Service
- Time Management
- Attention to Detail
- Multitasking
- Reliability
- Adaptability and Flexibility
- Data Entry
- Word Processing & typing
Affiliations
- Fortnightly Club of Catskill
Timeline
Associate Provider Installation Specialist
Optum
10.2020 - Current
Data Analyst
Optum
10.2016 - 09.2020
Data Entry Clerk Non-Keyables
Optum
01.2008 - 09.2016
Claims Processor
Optum
01.2001 - 12.2007
Member Provider Services Rep
ACN - American Chiropractic Network
04.1997 - 12.2000
Associate of Arts - Fashion Merchandising
Patricia Stevens Career College
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