Hafsa Haque
Murphy
Summary
Dedicated and goal-oriented professional with four years of experience in coordinating business and healthcare operations. Proficient in administrative support, reporting, and managing databases across healthcare services. Currently pursuing an MBA to enhance my skills and further develop my professional expertise.
Overview
5
5
years of professional experience
Work History
Network Operations Coordinator II
BLUE CROSS BLUE SHIELD
05.2022 - Current
- Manage daily operations related to provider data management and network operations, ensuring efficient administrative processes.
- Develop and analyze detailed pricing reports in Excel for providers, utilizing advanced functions like pivot tables, VLOOKUP, and formulas.
- Prepare and generate daily reports for arbitration, ensuring that all data is accurate, while supporting decision-making in selecting arbitrators that align with the health plan's interests.
- Maintain strong relationships with providers, addressing claims-related issues, and providing necessary updates and adjustments.
- Create detailed briefs for arbitration, summarizing relevant data and insights to facilitate decision-making and dispute resolution.
Service Center Specialist
UNITED HEALTH GROUP; ABLETO
04.2021 - 11.2021
- Provided technical assistance and system support to the provider network, healthcare members, and various departments.
- Performed data entry in Salesforce to effectively manage provider and healthcare member services, ensuring accuracy and timeliness.
- Ensured high quality customer service by responding to health plan member inquiries, inbound calls, and voicemails.
- Processed medical records and claims with precision, ensuring all information was accurate and compliant with healthcare standards.
Medical Claims Analyst
HEAL 360 PRIMARY & URGENT CARE
06.2020 - 04.2021
- Processed large volumes of medical claims by updating and verifying information into EMR system to finalize reimbursement.
- Conducted thorough verification of medical codes and claims data to prevent errors and maintain data accuracy.
- Interpreted healthcare plans, benefits, coverage limits, and other policy provisions to ensure accurate reimbursement of services rendered.
- Consistently met weekly goals and deadlines, ensuring efficient claim processing and operational success.
Education
MBA - Business Administration And Management
Southern Methodist University
Dallas, TX05-2026
Bachelor of Science (B.S.) - Health Care Management
University of Texas at Dallas
Richardson, TX12.2020
Skills
- Data Analysis
- Reporting
- Microsoft Excel
- Operational Support
- Problem Solving
- Time Management
- Data Integration
- Data extraction & Transformation
Timeline
Network Operations Coordinator II
BLUE CROSS BLUE SHIELD
05.2022 - Current
Service Center Specialist
UNITED HEALTH GROUP; ABLETO
04.2021 - 11.2021
Medical Claims Analyst
HEAL 360 PRIMARY & URGENT CARE
06.2020 - 04.2021
Bachelor of Science (B.S.) - Health Care Management
University of Texas at Dallas
MBA - Business Administration And Management
Southern Methodist University
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