Maya Washington

• Coordinated daily team workflows, maintaining consistent service delivery while meeting healthcare operations standards.
• Collaborated with cross-functional partners to remove operational barriers while supporting care coordination.
• Delivered coaching on policies, procedures, and quality expectations to improve performance and accountability.
• oversees day-to-day activities, coaches mentors, motivates, supports, and develops support team, participates in and/or supports performance management/corrective action plans, goal setting/review, delivers regular guidance and 1-1 check-ins
• assesses team member needs and training requirements to sustain efficient, accurate production.
• Fosters accountability and collaboration to advance overall team success through consistent allocation of time to supervisory work.

• Serve as lead and primary contact in the absence of management.
• Identifies and reports trend impacts on PDM.
• Communicated information to internal and external partners to optimize process execution.
• Maintained provider demographic data accuracy across internal systems and downstream reporting workflows.
• Validated provider records against credentialing documents and source data for consistency.
• Resolved data discrepancies by coordinating updates with operations and network management teams.

• streamlining provider and practitioner enrollment into provider data management system (facets)
• maintaining providers and practitioners updates with claims payment and directory information.
• processing provider agreement changes.
• serving as point of contact for delegated credentialing provider organizations.
• Contributing to the Facets upgrade testing.
• Conducted analysis and investigation of escalated provider issues to pinpoint root cause and track trends.

.

• Managed member and provider inbound calls and executed outbound follow-up calls.
• Delivered issue resolution ensuring the highest level of satisfaction
• Provided support for questions and concerns related to benefits referrals and authorizations for both members and providers.
• Resolved member inquiries regarding benefits, eligibility, claims, and authorization status with accurate service documentation.
• Managed complex escalations, coordinating with internal teams to deliver timely solutions and consistent follow-through.