JaVoni Bell
Sacramento,CA
Summary
Dynamic Physician Service Advisor with a proven track record at Altais, excelling in provider relations and contract negotiations. Skilled in medical terminology and effective communication, I foster collaborative relationships, resolve complex issues, and enhance operational efficiency, ensuring optimal patient care and satisfaction.
Overview
18
18
years of professional experience
Work History
Physician Service Advisor
Altais
09.2024 - Current
- Act as an internal and external liaison, resolving challenges promptly and promoting positive relationships with physicians and office staff.
- Communicate challenges and deficiencies on behalf of the physician network, escalating issues as needed and ensuring timely resolutions.
- Educate physician practices on new and existing policies and procedures, including medical management review processes, claims payment policies, and clinical coding processes.
- Assist with onboarding new physicians and staff, handling account setups, agreements, and paperwork to ensure effective use of Altais products and services.
Patient Care Coordinator
Nivano Physicians
Sacramento, CA
03.2021 - 09.2024
- Coordinate the authorization and referral process for each assigned referral.
- Make outreach efforts to insurances, patients, specialist office and care team as set forth by department guideline and clinical priorities.
- Interacts collaboratively with clinical staff, other ancillary departments, and outside entities (specialist office, insurances, etc.
- Resolves differences in a spirit of cooperation and creates solutions, which benefits all parties, especially clinic patients.
Provider Relations and Contracting Specialist
Health Net, Centene
Sacramento, CA
11.2007 - 09.2020
- Collaborate closely with Medical Management, Claims Network Analytics, and Sales to meet aggressive regional goals
- Identify strategic opportunities within local market (i.e., network expansion opportunities, utilization or unit cost excesses, etc.)
- Draft, review, coordinate negotiation of, and support execution and implementation of payer contracts to promote favorable and equitable terms for Organization
- Facilitate resolution of escalated contractual, payer policy, operational, and claims-related issues through collaboration with managed care organizations and internal stakeholders.
Education
High School Diploma -
Florin High School
Sacramento, CABachelor of Arts - Health Information Technology
Western Governors University
Salt Lake City, UTSkills
- Medical Terminology
- Patient Referrals
- Contracting
- Provider Relations
Timeline
Physician Service Advisor
Altais
09.2024 - Current
Patient Care Coordinator
Nivano Physicians
03.2021 - 09.2024
Provider Relations and Contracting Specialist
Health Net, Centene
11.2007 - 09.2020
High School Diploma -
Florin High School
Bachelor of Arts - Health Information Technology
Western Governors University