Hi, I’m
Kimbra Monroe
Atlanta,Georgia
Summary
Encouraging professional and analytical problem-solver with talents for team building, leading and motivating, as well as excellent customer relations aptitude and relationship-building skills. Dedicated to applying training, monitoring and morale-building abilities to enhance employee engagement and boost performance. Organized, dependable and successful at managing multiple priorities with a positive attitude.
Overview
17
years of professional experience
Work History
Privia Health
Provider Information Consultant
11.2020 - Current
Job overview
- Analyze large and complex data sets to identify trends, patterns, and insights and maintain dashboards
- Validate data for completeness and accuracy based on guidelines set by project stakeholders or data management systems
- Research data quality issue trends, identify resolutions, and update systems as required
- Effectively collaborate with technology and data stakeholders in the implementation of data warehouse solutions.
- Provide 2nd and 3rd-level technical support and troubleshooting to internal and external clients.
- Utilized electronic medical record systems to store, retrieve, and process provider data.
WellCare Health Plans
Senior Manager Provider Operations
08.2017 - 11.2020
Job overview
- Improved processes resulting in cost savings of total budget by 78.3%.
- Increased staff efficiency by 26.4%, reducing cycle time per task from 3.5 days to 2.6 days.
- Developed data validation and control process to ensure 100% accuracy in data entry.
- Implemented provider operations job aid that improved provider loading timeliness by 38%.
- Achieved 100% compliance related to credentialing, provider demographics, and provider claims.
- Provided leadership for continual management and employee training initiatives.
- Launched staff engagement, gender diversity, and cultural programs in addition to a robust reporting tool that increased operational quality.
WellCare Health Plans
Manager Provider Operations
03.2012 - 08.2017
Job overview
- Developed systems and procedures to improve operational quality and team efficiency.
- Researched and resolved disputes, billing discrepancies, and claims efficiently to maintain customer satisfaction, boosting satisfaction ratings to 87%.
- Increased provider satisfaction scores by 25% by collecting and credentialing demographic updates, investigating claims and inquiries, and overseeing network integrity.
- Fostered strong, positive relationships with key providers by coordinating, facilitating, and leading partnership meetings and identifying on-site enrollment opportunities.
- Introduced new methods, practices, and systems to reduce provider loading turnaround time.
- Recruited, interviewed, and hired employees and implemented a mentoring program to promote positive feedback and engagement.
WellCare Health Plans
Supervisor Provider Operations
03.2010 - 03.2012
Job overview
- Hired, managed, developed and trained staff, established and monitored goals, conducted performance reviews and administered salaries for staff.
- Coordinated individual duties after careful evaluation of each employee's skill level and knowledge.
- Delegated tasks to administrative support staff to organize and improve office efficiency.
- Established positive and effective communication among unit staff and organization leadership, reducing miscommunications, and missed deadlines.
- Managed provider relations mailbox by triaging inquiries, facilitating the resolution of incoming requests, and forwarding requests to appropriate parties.
WellCare Health Plans
Senior Provider Operations Associate
06.2006 - 03.2010
Job overview
- Executed and maintained quality control processes to meet criteria and standards and increase customer satisfaction.
- Built relationships with external stakeholders to establish seamless operations.
- Analyzed data to identify trends and patterns and exercise strategic decisions.
- Collaborated with other departments to establish smooth implementation of operational processes and procedures.
- Prepared and processed provider enrollments with Medicare and Medicaid for multiple states.
- Updated, proofed, and distributed provider directories, using LexisNexis.
Education
University of Phoenix- Dunwoody CampusAtlanta, GA
Master of Business Administration
University of Maryland - Eastern ShorePrincess Anne, MD
Bachelor of Science from Business Administration
Skills
- Data Communications
- Data Integrity
- Project Audits
- System Mapping
- Credentialing
- Network Management
- Salesforce
- Agile Environment
- Network Management
- Salesforce
- Agile Environment
- Demographics Information
- Network Management
- Salesforce
- Agile Environment
- Network Management
- Salesforce
- Agile Environment
- Provider Enrollment
- Workflow Analysis
- Health Plan Operations
- Provider Orientations
- Provider Relationship Management
- Team Meetings
- Employee Coaching and Mentoring
- Network Management
- Salesforce
- Agile Environment
- Network Management
- Salesforce
- Agile Environment
- Data Acquisition
- Credential Verification
- Management Collaboration
- Insurance Credentialing Processes
- Credentialing Documentation
- Database Maintenance
- Onboard New Hires
Availability
See my work availability
Not Available
Available
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Provider Information Consultant
Privia Health
11.2020 - Current
Senior Manager Provider Operations
WellCare Health Plans
08.2017 - 11.2020
Manager Provider Operations
WellCare Health Plans
03.2012 - 08.2017
Supervisor Provider Operations
WellCare Health Plans
03.2010 - 03.2012
Senior Provider Operations Associate
WellCare Health Plans
06.2006 - 03.2010
University of Phoenix- Dunwoody Campus
Master of Business Administration
University of Maryland - Eastern Shore
Bachelor of Science from Business Administration
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