Okeyia Williams

Garner,NC

Summary

Experienced healthcare professional with over 4 years of expertise in EDI transactions, regulatory compliance, and project management. Proficient in data analysis, process optimization, and cross-functional collaboration. Known for ensuring regulatory adherence, improving operational eﬃciency, and delivering successful outcomes in high-volume, fast-paced environments. Adept at managing complex projects and maintaining data integrity while fostering stakeholder engagement.

Overview

years of professional experience

Work History

EDI Claims Analyst (Contract)

Blu Omega

02.2025 - Current

Serve as a subject matter expert in EDI transactions, specializing in interpreting and analyzing raw 837 claim files to ensure data integrity and compliance with HRSA guidelines.
Collaborate in weekly strategic meetings with HRSA to address evolving data requests, project updates, and Uninsured Program policy implementations.
Translate complex EDI data into actionable insights to assist internal teams and HRSA stakeholders in understanding claim trends and anomalies.
Provide technical guidance to cross-functional teams on claims processing workflows, EDI standards, and billing compliance related to uninsured patient claims.
Document and communicate process improvements and data reporting enhancements to meet evolving federal program requirements.
Analyze and implement business requirements for claims editing to align with CMS, Medicare, and HRSA Uninsured Program guidelines.
Conduct in-depth research on HRSA Uninsured Program requirements, ensuring compliance enforcement through appropriate claim edits and adjudication logic.
Interpret and apply CMS regulations for claim processing and reimbursement, including NCCI, bundling/unbundling, PFS, ICD-10, CPT, HCPCS, and MUEs.

Revenue Cycle Analyst

Natera Inc.

10.2023 - 02.2025

Analyzed and resolved complex EDI denial trends, ensuring compliance with regulatory standards and improving data accuracy by 20%.
Developed and presented performance reports to senior leadership, providing actionable insights to guide regulatory and operational strategies.
Coordinated with payers to address compliance issues, enhancing claims approval rates and maintaining HIPAA compliance.
Monitored and reported key performance indicators (KPIs) to streamline workflows and ensure timely submissions.

EDI Enrollment Analyst (Contract)

Innova’s Solutions Agency

03.2023 - 10.2023

Oversaw provider enrollment for 50+ providers, achieving a 95% on-time completion rate and ensuring compliance with payer requirements.
Conducted data audits to identify compliance gaps, improving enrollment accuracy by 15%.
Managed communications with stakeholders, ensuring adherence to EDI standards and regulatory guidelines.
Processed over 300 electronic claims per day, ensuring accuracy and timeliness to meet payer requirements and minimize errors in data exchange.
Successfully enrolled 50+ providers across EDI platforms, reducing enrollment time by 15% and ensuring compliance with data standards (834,835, 837).
Conducted data audits to improve quality and identify areas for optimization, enhancing claims accuracy and increasing approval rates.
Responded to inquiries and resolved issues within 24 hours, maintaining high client satisfaction and adherence to industry data standards.

EDI Enrollment Analyst I

Olive AI

01.2022 - 04.2023

Facilitated seamless data exchange by enrolling 200+ clients on EDI platforms, ensuring adherence to industry regulations.
Conducted audits of EDI transactions, identifying root causes of errors and implementing corrective actions to enhance compliance.
Maintained comprehensive project documentation and provided regular updates to stakeholders, aligning goals with regulatory standards.
Collaborated with cross-functional teams to resolve enrollment-related issues, maintaining high data integrity and client satisfaction.
Worked cross-functionally with healthcare providers, payers, and internal teams to resolve project roadblocks, ensuring seamless client onboarding.
Maintained detailed project documentation and communicated project updates to stakeholders, aligning project goals with company objectives.

Education

Bachelor of Science - Social Work

North Carolina Central University

Durham, NC

Skills

Regulatory Compliance: Expertise in HIPAA regulations,payer policies, and industry best practices
Project Management: End-to-end project planning,milestone tracking, stakeholder communication, and risk mitigation
Data Analysis & Reporting: Advanced proficiency in Power BI, SQL Server, and Excel for data visualization and performance metrics

Process Improvement: Workflow optimization,compliance audits, and strategic initiatives to enhance eﬃciency and accuracy
Stakeholder Management: Eﬀective communication,issue resolution, and collaboration with cross-functional teams
Software Proficiency: EPIC, Oracle, SAP, EDInsight,Veradigm PM, Microsoft Oﬃce Suite, Salesforce

Websites

https://www.linkedin.com/in/okeyia-williams

Timeline