Lanita Carver
Summary
Efficient Provider Enrollment Specialist known for high productivity and ability to complete tasks swiftly. Specialized in navigating complex healthcare systems, understanding regulatory compliance, and managing provider data with accuracy. Excel in communication, problem-solving, and time management, ensuring smooth enrollment processes and maintaining strong relationships with providers.
Overview
11
11
years of professional experience
Work History
Provider Enrollment Specialist II
CHRISTUS Health
09.2025 - Current
- Prepared and submitted Medicare and Medicaid applications for new and existing provider enrollments, following up with carriers to ensure timely processing.
- Collected and maintained provider data for Medicare and Medicaid enrollment, ensuring accuracy and compliance.
- Ensured adherence to Medicare and Medicaid provider enrollment guidelines for accurate processing.
- Reviewed managed care contracts for billing and payment terms, ensuring alignment with compliance and reimbursement standards.
- Identifies problem accounts and follows through to completion
Patient Financial Service Representative Senior
CHRISTUS Health
09.2024 - 09.2025
- Corrected claims in RTP status per Medicare guidelines, enhancing billing accuracy and facilitating timely reimbursement.
- Maintained active knowledge of governmental agency requirements and updates for compliance.
- Liaised between external vendors and revenue cycle departments, monitoring activities to optimize account collection processes.
- Generated reports identifying outstanding claims issues with provider numbers and non-payment, enabling targeted follow-up actions.
Revenue Specialist II Medicare Patient Accounts
DaVita Kidney Care
09.2023 - 09.2024
- Analyzed and prepared claims for accuracy, attached docs, referrals, and treatment plans for Medicare patient accounts at DaVita Kidney Care.
- Processed payer, partner, and customer requests, ensuring accurate billing and compliance with single patient agreements.
- Collaborated with revenue operations teams to establish objects, contract requirements, and system logic in billing system.
AR Supervisor
Professional Medical Services
08.2019 - 10.2023
- Resolved payer responses through comprehensive claims research and analysis, utilizing 276/277 transactions and 835/EOB adjustment reasons to clarify issues.
- Initiated calls to payers to address claim errors and verify provider enrollment status, enhancing communication efficiency.
- Analyzed claims for accuracy using Epic EHR and Availity Revenue Cycle Management, ensuring timely resolution of discrepancies.
President
CW Ternary Logistics & Transportation LLC
03.2020 - 04.2023
- Oversaw drivers to optimize operations at CW Ternary Logistics & Transportation LLC.
- Collaborated with shippers and brokers to secure optimal transportation solutions.
- Facilitated new hire paperwork for DOT compliance and coordinated employee drug screening tests.
Work Comp Specialist
Parallon
10.2016 - 08.2019
- Analyzed and prepared claims, referrals, and treatment plans for Workers’ Compensation and Private Pay.
- Coordinated insurance plans and corporate protocols to optimize management of commercial and Workers’ Compensation claims.
- Communicated with payers to resolve claim errors, facilitate provider enrollment, verify patient eligibility, and track claim status, rejections, and appeals.
Member Service Representative
Aetna, a CVS Health Company
06.2015 - 10.2016
- Provided high-quality customer service to members, resolving inquiries, claims, and appeals efficiently.
- Addressed inquiries on benefits, EOBs, and patient eligibility, demonstrating comprehensive knowledge of services offered.
- Surpassed member expectations through diligent adherence to company policies and procedures.
- Accurately updated and processed claims, contributing to enhanced member satisfaction.
Education
Bachelor's Degree - Social Work
University of Phoenix
01-2027
Associate's Degree - Health/Health Care Administration/Management
University of Phoenix
01-2016
High School Diploma -
MacArthur High School
Skills
- EHR systems experience
- Epic
- Enrollment coordination
- Claims processing
- Provider relations
- Compliance review
- Issue resolution
- Process improvement
- Data analysis
- Microsoft Office skills
- 10-key data entry
- 40 wpm typing
- Office equipment proficiency
Timeline
Provider Enrollment Specialist II
CHRISTUS Health
09.2025 - Current
Patient Financial Service Representative Senior
CHRISTUS Health
09.2024 - 09.2025
Revenue Specialist II Medicare Patient Accounts
DaVita Kidney Care
09.2023 - 09.2024
President
CW Ternary Logistics & Transportation LLC
03.2020 - 04.2023
AR Supervisor
Professional Medical Services
08.2019 - 10.2023
Work Comp Specialist
Parallon
10.2016 - 08.2019
Member Service Representative
Aetna, a CVS Health Company
06.2015 - 10.2016
Bachelor's Degree - Social Work
University of Phoenix
Associate's Degree - Health/Health Care Administration/Management
University of Phoenix
High School Diploma -
MacArthur High School