Renee L. Daniel
Maryland Heights,MO
Summary
Experienced and reliable Lead Provider Service Associate with 9+ years, skilled in addressing customer concerns, leading teams, and consistently surpassing company objectives for enhanced customer satisfaction.
Overview
9
9
years of professional experience
Work History
Lead Provider Service Associate
Magellan Health/Evolent
Maryland Heights, MO
09.2021 - Current
- Lead and organize team meetings of 22 people, presenting monthly PowerPoint on key subjects.
- Foster teamwork among leads, coordinate schedules, and facilitate weekly brainstorm meetings for cohesive support.
- Mentor 16-22 mentees monthly throughout the year.
- Coach on job performance improvement, focusing on metrics, structure, and adherence, facilitate team chats, and manage 38+ monthly emails on error reports.
- Collaborate on knowledge-reinforcing games, conduct 9 calibrations, and perform 54+ monthly call monitors for quality coaching.
Provider Service Associate II Specialist
Magellan Health
Maryland Heights
11.2015 - 09.2021
- Provided customer service for various services to providers, members, health plan representatives, imaging facilities, and internal staff.
- Managed incoming authorizations, ensuring adherence to SOPs and meeting quality control timelines per contractual agreements with health plans.
- Processed 20-30 escalations per day for privileging/credentialing issues, verification and redirection of cases to cost-effective participating facilities, and fraud prevention and quality control.
- Provided troubleshooting support on the Provider Service Line (PSL) for RADMD website and Magellan Provider Portal, assisted Awesome support team for internal staff, and served as backup for the inbound team during call queues.
Customer Service Associate
Kelly Services/Cigna
Bourbonnais, IL
12.2014 - 06.2015
- Processed medication authorization requests through mail, phone, and fax, ensuring timely and accurate handling.
- Responded to inquiries from policyholders, providers, and members, providing clear and detailed information on benefits determination status.
- Applied comprehensive knowledge of medical and insurance industry terminology, including proficiency in CPT/ICD-10 codes.
Education
Health Information Technology -
St. Louis Community College
St Louis, MO05.2025
Skills
- Program Administration
- Operational Supervision
- Leadership
- Report Development
- Office Administration
- Creative Problem-Solving
- Procedure Development
- Medical Processes
Timeline
Lead Provider Service Associate
Magellan Health/Evolent
09.2021 - Current
Provider Service Associate II Specialist
Magellan Health
11.2015 - 09.2021
Customer Service Associate
Kelly Services/Cigna
12.2014 - 06.2015
Health Information Technology -
St. Louis Community College
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