Marissa Brown
Atlanta,GA
Summary
Dynamic Network Operations Specialist at Optum Serve, with a strong history of optimizing clinical delivery systems and enhancing examiner satisfaction. Proven expertise in data management, issue resolution, and effective communication. Recognized for delivering exceptional customer service and leveraging the MS Office Suite to streamline operations. Skilled in building cross-functional relationships, and driving continuous process improvements.
Overview
12
12
years of professional experience
Work History
Dedicated Network Operations Specialist
Optum Serve
03.2024 - Current
- Serve as the primary point of contact for the Dedicated Network, assessing examiner concerns, and implementing effective solutions across a variety of clinical delivery systems.
- Manage examiner availability in MedNet to ensure accurate scheduling and staffing.
- Act as a liaison between examiners and leadership, voicing examiner concerns in Operations and POD meetings to drive process improvements.
- Utilize provider input through emails, complaints, and discussions to create targeted solutions, including corrective measures, leadership recommendations, and resolution plans.
Senior Marketing Event Coordinator
Optum Serve
11.2021 - 03.2024
- Assigned and staffed qualified, credentialed providers and practitioners for health care events.
- Created optimal team combinations by assessing service requests and matching them with provider capabilities.
- Negotiated event-specific fee schedules and concessions.
- Maintained comprehensive records of event aspects, including communication and documentation, using MedNet.
- Conducted cost comparisons for each event, evaluating multiple providers to ensure they are aligned with our quality standards, and pricing constraints.
- Verified services with providers, reviewed staff credentials, equipment details, and onsite availability for events.
- Monitored event activities to ensure compliance with regulations, participant satisfaction, and prompt resolution of issues.
- Addressed complex concerns raised by staffing partners, proactively developed effective solutions, and implemented them for optimal outcomes.
- Coordinated and updated health care provider training schedules.
- Managed and delivered initial and ongoing education to on-location event staff.
- Collaborated with the Event Operations Leadership Team to implement, update, administer, and evaluate internal and external processes and materials supporting Optum Serve's network providers and practitioners in meeting service requirements.
- Oversaw and supervised staff to ensure strict adherence to infectious disease regulations and safety protocols.
- Served as a mentor and Subject Matter Expert (SME) for event coordinators, providing guidance and support in their daily tasks.
- Functioned as a liaison between upper management and team members, effectively communicating goals, expectations, and feedback.
Marketing Event Coordinator
Logistics Health (LHI)
09.2020 - 11.2021
- Collaborated closely with provider agencies to efficiently staff infectious disease health testing and vaccine events.
- Verified the team’s availability for designated event dates and times, ensuring proper staffing arrangements.
- Adjusted staffing schedules, as necessary, during events to accommodate changing requirements, or increased demand.
- Oversaw the credentialing and qualification process for all practitioners involved in service delivery.
- Documented and maintained comprehensive records of all event aspects, including staffing schedules, travel arrangements, and equipment.
- Managed and supervised staff to ensure strict compliance with infectious disease regulations and safety protocols.
- Collaborated closely with provider agencies to proactively address any concerns or issues that may arise with onsite staff.
- Mentored and provided assistance to newly hired coordinators, offering comprehensive training and support with their daily tasks.
Provider Data Specialist
Optum
06.2020 - 09.2020
- Accountable for the efficient management, maintenance, and enhancement of provider databases.
- Leveraged loading systems to extract data for analysis reports.
- Reviewed system results to ensure the accuracy of keyed data.
- Formatted data for loading into PIMS, and other respective systems.
- Conducted extensive research and sourced accurate provider data from multiple databases, such as NDB, Optum Database, NPPES, and Health Guide USA.
- Oversaw communication processes with other departments to drive database improvements.
Provider Data Analyst
United Healthcare
07.2019 - 06.2020
- Led the initiative to establish and uphold company-wide standards for ensuring database integrity and quality assurance.
- Coordinated efforts to clean and maintain current provider data through corrective activities.
- Engaged in direct communication and interviews with healthcare providers to gather and verify accurate provider data.
- Employed data systems and tools to accurately format and input relevant details and information.
- Conducted regular audits, and delivered constructive feedback to minimize errors, and drive process improvements and performance enhancements.
Provider Data Attestation Representative
United Healthcare
03.2017 - 07.2019
- Orchestrated the seamless completion of provider attestation, ensuring accurate representation of provider demographics, and product participation across My Practice Profile and internal systems of United Healthcare.
- Provided training and coaching to providers on UHC technology and website usage, enhancing awareness and ease of use.
- Educated providers on UHC products and their participation status, ensuring 100% accuracy.
- Assumed the role of Team Lead, serving as the primary point of contact for enhancing team efficiency in program and system operations, conducting group TIN checks for claims activity, addressing concerns, implementing daily procedures, and sharing best practices.
- Functioned as a SME in NDB (National Database), retrieving data on provider groups, educating team members on findings, and assisting with research on provider claims and contract activity.
- Functioned as a Contract Analysis SME, reviewing and submitting provider group cases involving inactivity and TIN closures.
Referral & Precertification Specialist
Dekalb Medical Physicians Group
02.2013 - 07.2016
- Acted as a pivotal liaison among physician offices, insurance companies, and patients, streamlining communication and optimizing service delivery.
- Utilized ICD-9, ICD-10, and CPT coding to facilitate referral authorizations.
- Assumed responsibility for validating eligibility and exhibited expertise in various health care benefit plans, including HMO, POS, and PPO.
- Secured authorizations from insurance providers for diagnostic procedures, and coordinated scheduled exams post-approval of authorization.
- Employed written, telephonic, and online platforms to gather, verify, record, and relay referral and preauthorization details to physician offices and patients.
- Informed patients promptly about the progress of their submitted referral requests. Managed urgent authorization requests from attending physicians with efficiency and poise.
- Mentored new team members, providing comprehensive training in referral and prior authorization processes.
Education
Bachelor of Arts - Broadcast Journalism
Howard University
Washington, D.C.05.1998
Skills
- Proficient in PC operation and MS Office Suite (Word, Excel, PowerPoint, Outlook, OneNote, Google Drive, and Docs)
- Expert in staying connected remotely through various communication channels, including chat platforms, conference calls, video meetings, and email correspondence
- Experienced in utilizing Microsoft Teams, Google Chat, Zoom, Skype, and SharePoint
- Skilled in managing client expectations, delivering on commitments, and providing excellent customer service
- Experienced in working within a clinical environment
- Familiarity with medical terminology
Timeline
Dedicated Network Operations Specialist
Optum Serve
03.2024 - Current
Senior Marketing Event Coordinator
Optum Serve
11.2021 - 03.2024
Marketing Event Coordinator
Logistics Health (LHI)
09.2020 - 11.2021
Provider Data Specialist
Optum
06.2020 - 09.2020
Provider Data Analyst
United Healthcare
07.2019 - 06.2020
Provider Data Attestation Representative
United Healthcare
03.2017 - 07.2019
Referral & Precertification Specialist
Dekalb Medical Physicians Group
02.2013 - 07.2016
Bachelor of Arts - Broadcast Journalism
Howard University
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