ISABELLA MILAZZO
Mesa,AZ
Summary
Dedicated professional seeking growth within a HealthCare environment. Thrives in a collaborative team environment, adept at assisting with diverse tasks and implementing innovative solutions. Skilled in effective communication via phone and email to resolve workload efficiently. Detail-oriented with expertise in reviewing and ensuring accuracy and appropriateness of legal documents and agreements. Overall goal is to achieve career growth in a healthcare industry.
Overview
9
9
years of professional experience
Work History
Provider Relation Representative
Triwest HealthCare Alliance
08.2022 - Current
- Provided guidance on contract language, policy interpretation and reimbursement procedures to providers.
- Cultivated strong relationships to maintain provider network knowledge and implement corrective actions for ongoing issues.
- Assisted providers in understanding their contractual obligations and ensured timely resolution of any discrepancies or disputes.
- Collaborated with other departments within the organization to resolve complex issues related to provider relations activities.
- Reimbursement rates for CCN and Tricare
- CMAC
- CMS
- Maintained exceptional levels of customer assistance
- Ensures compliance with network subcontractors and Triwest's stance on provider education needs.
- Facilitates resolution of escalated provider issues.
- Organized on-time completion for products
- Understanding claims issues and terminology.
- Researched and developed provider network strategies to ensure compliance with contractual obligations.
- Developed and maintained strong relationships with providers by responding promptly to inquiries, resolving issues and providing ongoing support.
- Handled and understanding old PC3 contracts,CCN, direct, third party, and T5 contracts.
- Liaised with customers, addressed inquiries, handled meeting requests and answer billing questions to provide outstanding customer care.
- Read through contracts, regulations and procedural guidelines to verify comprehension and compliance.
- Well versed in data management programs such as:
- Self Service Reporting (SSRS)
- Sharepoint
- Anchor Point
- PGBA Portal
- Tableau
- Visual Cactus
- Excel
- Microsoft word
- Powerpoint
- Adobe
- NPPES
- VA portal
- Well Versed in contract management programs such as:
- Salesforce
- Apttus
- TriWest 360
Contract Support Specialist
Triwest HealthCare Alliance
05.2020 - 08.2022
- Analyzing problems and inquiries comprehensively
- Logged electronic requests and distributed to relevant departments promptly.
- Scanned/images into contract management system in a timely manner.
- Review agreements for any redline changes.
- Maintain awareness of the latest protocols and standards in TriWest
- Guaranteed timely completion of requirements
- Drafted contracts, reviewed legal documents, and ensured compliance with organizational standards.
- Developed contract templates and processes to streamline contracting procedures.
- Handled old PC3, CCN, direct and third party contracts.
Guest Teacher
Deer Valley Unified School District
09.2018 - 05.2020
- Facilitated meetings with team members to discuss key issues on projects
- Conferred with parents, teachers, counselors, and administrators to assist in setting goal-oriented structures for students.
- Developed Individual Education Plans for students with disabilities.
- Provided instruction in academic, communication, and social skills to special education students.
- Identified learning needs of students with disabilities and implemented appropriate interventions.
- Assisted in the development of IEP goals based on data analysis.
- Maintained accurate records of student progress towards IEP goals.
- Developed IEP to leverage developmental practices and educational theories to achieve educational objectives.
Hospitality Service Industry
Apollo Global Management
06.2015 - 01.2018
- Provided training on operating systems, processes, and procedures to new staff members.
- Ensured compliance with health and safety regulations in all areas of hospitality services operations.
- Developed and implemented policies, procedures, and standards to ensure quality of service and customer satisfaction.
- Created operational plans for the hospitality services department.
- Assist with customer on daily deals and merchandise.
- Demonstrate a culture of ethical conduct, safety, and compliance.
- Oversaw facility's stock and inventory.
- Reviewed business documentation.
Education
Bachelor of Science - Elementary & Special Education
Northern Arizona University
05.2018
High-school Diploma -
Boulder Creek HighSchool
05.2012
Skills
- Data Management and Presentation Expertise
- Skilled in Task Management
- Proficient in exercising good judgment to achieve positive results by following defined processes
- Critical Analysis
- Claims reviewing and resolution
- Provider support
- Network and data analysis
- Workflow Planning
- Adaptability and Flexibility
- Time management and organizing skills
- Coordinating network needs and managing network relations
- Well versed in legal contract terminology
References
- Sigmund, Boloz, Professor of Education, (928)-225-755
- Amy, Bennett, Special Education Strategist, amy.Bennet@dvusd.org
- Cindy, Arthur, 1st Grade Teacher, cindy.Arthur@dvusd.org
- Julie, Bucher, Intervention Specialist SPED, julie.bucher@dvusd.org
- Amanda, Soerheide, Manager, (602)-582-5256, Apollo Global
Timeline
Provider Relation Representative
Triwest HealthCare Alliance
08.2022 - Current
Contract Support Specialist
Triwest HealthCare Alliance
05.2020 - 08.2022
Guest Teacher
Deer Valley Unified School District
09.2018 - 05.2020
Hospitality Service Industry
Apollo Global Management
06.2015 - 01.2018
Bachelor of Science - Elementary & Special Education
Northern Arizona University
High-school Diploma -
Boulder Creek HighSchool
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