Kinshasha Dunton
Columbia,SC
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
26
26
years of professional experience
Work History
Provider Relations Consultant
BlueCross BlueShield Of SC
02.2024 - Current
- Provide ongoing support to providers post-Enrollment Portal implementation, ensuring long-term success of implemented solutions.
- Delivering high-quality presentations to providers in-person, by telephone or email effectively communicating provider-based information.
- Optimized provider experience by delivering timely responses to inquiries and effectively troubleshooting issues.
- Responding to inquiries received in the PIMS/Contracting escalations email account within two business days.
PIMS QC & Training Analyst
BCBSSC
05.2018 - 02.2024
- Developed training curriculum to increase content knowledge, call quality scores, enrollment processing scores and productivity.
- Created user-friendly training for onboarding new employees to the Provider Enrollment area.
- Implemented training program for new Provider Enrollment call center in 2018.
- Reviewing data entries made by PIMS Enrollment Analysts for quality and accuracy.
- Maintained training through Webex, Avaya Conference calls and Microsoft Teams.
- Successfully transitioned face-to-face training programs to virtual formats during pandemic restrictions without compromising quality or participant satisfaction.
Provider Enrollment Analyst - BCBSSC
12.2014 - 05.2018
- Determined the acceptability of provider enrollment applications and provide in-depth review and verification of provider data.
- Processed provider data information from the applications into the PIMS software.
- Cooperated with providers and provider representatives to supply enrollment applications and general information on the enrollment process.
- Participated on special projects related to provider files: responding to urgent requests, providing special training for other analysts assisting with enrollment.
- Database testing and updates for Providerlink and Docfinity software implementation.
Document Prep Technician
BCBSSC
09.2005 - 12.2014
- Addressed provider inquiries in a timely and accurate fashion; responded to all email inquiries within 48 hours.
- Assisted with process improvements related to NPI Implementation (2006).
- Ensured quality control by properly labeling, documenting, and storing samples according to established protocols.
Provider Services Representative
BlueCross BlueShield of SC
, SC
10.2001 - 09.2005
- Assisted providers with patient eligibility and benefit inquiries and claims' status.
- Cross-trained and provided back-up for other customer service representatives when needed.
- Handled written and web inquiries when the department needed additional help.
- Enhanced customer satisfaction by efficiently resolving provider inquiries and concerns.
French Instructor
Lower Richland High School
08.1998 - 06.2001
- Implemented innovative teaching techniques, such as flipped classrooms and project-based learning, to enhance the educational experience for students.
- Collaborated with colleagues to organize cultural events, connecting students to authentic experiences of French-speaking communities.
- Increased student engagement by incorporating French culture and media into lessons.
- Improved learning outcomes by adapting teaching methods to individual student needs.
- Developed comprehensive lesson plans that aligned with curriculum standards and focused on building language proficiency.
Education
Master of Arts - Education, Adult Education
University Of Phoenix
2017
Bachelor of Arts - French
Columbia College, Education
1998
Skills
- Microsoft Teams
- Avaya Conference
- Webex
- Microsoft office
- ASTD Training
- Quality Assurance
Timeline
Provider Relations Consultant
BlueCross BlueShield Of SC
02.2024 - Current
PIMS QC & Training Analyst
BCBSSC
05.2018 - 02.2024
Provider Enrollment Analyst - BCBSSC
12.2014 - 05.2018
Document Prep Technician
BCBSSC
09.2005 - 12.2014
Provider Services Representative
BlueCross BlueShield of SC
10.2001 - 09.2005
French Instructor
Lower Richland High School
08.1998 - 06.2001
Master of Arts - Education, Adult Education
University Of Phoenix
Bachelor of Arts - French
Columbia College, Education
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