Mary Janet Yeck
Virginia Beach,VA
Summary
Professional with over ten years' experience working in the healthcare and real estate industries. Strong analytical and organizational skills combined with knowledge of finance, transaction processing, and demonstrated ability to work collaboratively across all levels to meet all objectives and provide swift issue resolution. Technical proficiencies include Microsoft Excel, Database, Word, PowerPoint; JIRA; Facets; and Macess. Bilingual with fluency in both English and Tagalog.
Overview
20
20
years of professional experience
Work History
Provider Enrollment Specialist II
Sentara Healthcare
Virginia Beach, VA
06.2023 - 06.2024
- Managed the credentialing and payment systems.
- Responsible for all aspects of ensuring accurate and timely processing of provider set up to initiate credentialing, provider record updates and edits.
- Processed provider terminations, researched and resolved provider set up issues in the applicable systems.
- Successfully met the SLA within the department.
- Independently completed assigned projects.
- Collaborated with the team in creating process improvements.
- Worked remotely full-time.
Provider Reimbursement Administrator
Anthem, Inc.
Virginia Beach, VA
06.2016 - 12.2019
- Managed reimbursements as well as supporting provider reimbursement initiatives.
- Responsibilities included creating design documents, building network agreements in accordance with contracts, developing and implementing claims tests in Facets/NetworX, and researching both claims and contracts.
- Collaborated across departments to ensure greater quality of care and better healthcare provider credentials.
- Implemented multiple improvements geared towards greater clarity and understanding.
- Worked remotely full-time.
Business Analyst
Anthem, Inc.
Virginia Beach, VA
06.2015 - 06.2016
- Researched clients' objectives and issues and software best fitting their business needs as well as working collaboratively with the IT team to combine requirements with system design and testing.
- Drafted reports and created presentations for the state and served as point of contact for all software questions.
- Instituted new measures to improve reinsurance reporting and clarity.
- Supervised the 1099 process for all markets.
Realtor
Century 21
Virginia Beach, VA
01.2015 - 01.2016
Financial Coordinator
Anthem, Inc.
Virginia Beach, VA
03.2008 - 05.2015
- Managed multiple responsibilities, including administration of provider reimbursement process and cross-functional collaborations to resolve capitated payment problems, development and processing of annual 1099 forms for Amerigroup providers, vendor payments, reinsurance reports, and preparing payment requests.
- Processed all levies, stop payments, and garnishments against providers for all health plans.
- Served as departmental point of contact for provider queries.
- Created departmental policies and procedures.
- Led policy and procedure training for multiple departments.
Benefit Analyst
EDS Technologies
Virginia Beach, VA
05.2004 - 03.2008
- Managed benefits, including eligibility analysis, amount due, beneficiary and pension analysis and calculation, QDRO, and all related research.
- Determined participant medical, dental, and life insurance eligibility and payments.
- Reviewed and approved power of attorney requests as well as claims and appeals.
- Provided resolution for difficult issues and served as point of contact for questions.
- Member of Termination Vested Deferred Benefit and Annual True Up Projects teams.
- Supported installation and testing of clients' information systems.
Education
Associate of Science - Social Science
Tidewater Community College
Virginia Beach, VASkills
- Research
- Policy & Procedure Development
- Contracts
- Benefits & Claims Analysis
- Document Reviews & Processing
- Service Level Agreements
- Needs Analysis
- Billing & Payments
- Staff Training
Timeline
Provider Enrollment Specialist II
Sentara Healthcare
06.2023 - 06.2024
Provider Reimbursement Administrator
Anthem, Inc.
06.2016 - 12.2019
Business Analyst
Anthem, Inc.
06.2015 - 06.2016
Realtor
Century 21
01.2015 - 01.2016
Financial Coordinator
Anthem, Inc.
03.2008 - 05.2015
Benefit Analyst
EDS Technologies
05.2004 - 03.2008
Associate of Science - Social Science
Tidewater Community College