Kendra Wheatley
MN
Summary
Experienced Provider Relations Associate with over 7 years of healthcare and pharmacy benefit management (PBM) experience and more than 15 years of customer service and operations expertise. Proven ability to manage complex escalations, support pharmacy networks, and partner with internal stakeholders to deliver timely and effective solutions. Recognized for strong communication skills, attention to detail, problem-solving abilities, and commitment to exceptional customer service.
Overview
12
12
years of professional experience
Work History
Provider Relations Associate
Prime Therapeutics
Eagan, Minnesota
09.2019 - Current
- Serve as a primary point of contact for participating pharmacies, clients, and internal stakeholders regarding pharmacy benefit and claims-related inquiries.
- Collaborate with Network Management, Client Engagement, Benefit Operations, and other departments to resolve complex provider and pharmacy issues.
- Manage Issue Management Team (IMT) cases, including pharmacy outreach, root cause analysis, documentation, tracking, and resolution of high-priority and escalated concerns.
- Coordinate pharmacy outreach efforts to address claim processing issues, reimbursement concerns, network-related inquiries, and client escalations.
- Handle claim reversals, open billing window requests, drug pricing concerns, and provider escalations while ensuring timely resolution.
- Manage and triage the Provider Relations mailbox, directing requests to appropriate teams and facilitating end-to-end resolution.
- Conduct issue management activities, monitor case progress, and provide status updates to stakeholders.
- Complete projects independently while consistently meeting departmental service expectations and turnaround times.
- Deliver exceptional support to pharmacies, clients, and internal partners through effective communication and problem resolution.
- Manage escalated inquiries from pharmacy chains and clients to ensure prompt and accurate resolution.
Customer Experience Specialist (Repair)
Xfinity
Saint Paul, Minnesota
05.2014 - 09.2019
- Established customer relationships by effectively troubleshooting technical issues with cable, internet, and telephone services.
- Resolved billing concerns and provided product education to customers, resulting in improved customer satisfaction.
- Handled high volume of customer interactions, averaging 60 calls daily, ensuring timely support and issue resolution.
- Facilitated resolution of complex escalated customer concerns by assisting agents in problem-solving.
- Consistently exceeded monthly sales and performance goals.
- Served as a mentor and resource for newly hired representatives.
Education
High School Diploma -
Arlington High School
Saint Paul, MN06-2009
Associate of Science -
Century College
Saint Paul, MN09-2026
Skills
- Claims analysis
- Pharmacy operations
- Documentation management
- Microsoft Excel
- Microsoft Word
- Microsoft Outlook
- Time management
- Problem-solving
- Root cause identification
- Stakeholder communication
- Conflict resolution
- Customer service excellence
Timeline
Provider Relations Associate
Prime Therapeutics
09.2019 - Current
Customer Experience Specialist (Repair)
Xfinity
05.2014 - 09.2019
High School Diploma -
Arlington High School
Associate of Science -
Century College