Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Mo’neke Walton

Garland,TX

Summary

Dynamic and detail-oriented professional with a strong background in delivering exceptional administrative support within the medical field. Proven expertise in managing clinical facilities, resolving complex issues, and overseeing provider contracting processes, including amendment loading and demographic updates. Skilled in navigating certification requirements and maintaining accurate documentation to ensure compliance and operational efficiency. Eager to leverage skills and proficiency in a challenging new role that fosters growth and contributes to organizational success.

Overview

13
13
years of professional experience
1
1
Certification

Work History

Sr. Install Admin

Optum
10.2022 - Current
  • Payment Appendix Analysis
  • Conduct audits in partnership with the CME Team and conduct configuration analysis by reviewing configuration set-up and identifying root cause of findings.
  • Identify process improvement opportunities to improve accuracy and timeliness (i.e., automation, turnaround time, etc.)
  • Assist with Internal quality control points (Arch Review, testing) reporting services as required.
  • Working knowledge of Pricing Reimbursement for Physician, Facility/Ancillary provider.
  • Telecommuter

Provider Install Specialist

UnitedHealth Care
07.2019 - 10.2022
  • Interpret and clarify contract reimbursement methods.
  • Load provider contracts/fee schedules into the appropriate platform.
  • Communicate with internal and/or external business partners to verify contractual intent as required.
  • Generate and analyze various reports using applications such as MS Excel, SQL, or reporting services as required.
  • Working knowledge of Pricing Reimbursement for Physician, Facility/Ancillary provider.
  • Telecommuter

Provider Data Specialist

UnitedHealth Care
09.2016 - 07.2019
  • Database maintenance, reporting and extracting of data for various reports, analysis and initiating database improvement.
  • Responsibility of maintaining standards for database integrity and quality assurance, coordinate corrective activities to clean database and retain users, and manage communication processes with other departments regarding database improvements.
  • Telecommuter
  • Conducted regular training sessions for team members, reinforcing best practices in provider data management.
  • Facilitated effective communication between internal departments regarding updates or changes to provider information for seamless operations.

Clinical Administrative Associate

Optum
07.2012 - 09.2016
  • Provide claim and benefit information pertaining to mental health/substance abuse.
  • Research claim denials and appeal information.
  • ISet, Facets, Unix and claim systems expertise.
  • Managed confidential documents, safeguarding company information while maintaining strict adherence to privacy protocols.
  • Provided exceptional customer service to both internal and external clients, fostering strong professional relationships.

Education

Business Management (AAS) -

Collin College
Plano, TX
01.2017

Pharmacy Technician -

Remington College
Garland, TX
02.2010

High School -

Garland High School
Garland, TX
01.1996

Skills

  • Provider data expertise with excellent oral and written communication skills
  • Knowledge of federal and state laws pertaining to Medicare and Medicaid
  • Possess strong time management and organizational skills
  • Time management
  • Problem-solving
  • Teamwork and collaboration
  • Flexible and adaptable

Certification

  • CPhT - Certified Pharmacy Technician

Timeline

Sr. Install Admin

Optum
10.2022 - Current

Provider Install Specialist

UnitedHealth Care
07.2019 - 10.2022

Provider Data Specialist

UnitedHealth Care
09.2016 - 07.2019

Clinical Administrative Associate

Optum
07.2012 - 09.2016

Business Management (AAS) -

Collin College

Pharmacy Technician -

Remington College

High School -

Garland High School

Similar Profiles

CREATE PROFILE