Rhonda Smith
El Paso,TX
Summary
Dedicated communicator with expertise in client oversight, issue resolution, and presentation. Proven ability to juggle multiple tasks and projects simultaneously. Possesses excellent business knowledge within the field.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Nursing Facility Provider Consultant
Amerigroup
03.2015 - 02.2024
- Provided reliable and efficient customer support to NF providers, addressing questions and concerns related to the status of Medicaid claims
- Utilized necessary resources and efficiently navigated systems to accurately verify eligibility and provide verification of benefits
- Assisted and facilitated provider setup and utilization of Provider Portal
- Collaborated with staff members to identify process improvements
- Established and maintained effective communication with colleagues and facility personnel
- Visited NF providers on a regular basis to enhance their business, ranging from analyzing quarterly statistics with staff to delivering training sessions for NF business office.
- Demonstrated strong communication and decision-making skills
- Providing prompt and accurate responses to provider inquiries
- Developing and maintaining provider contracts in contract management software while ensuring completion of accurately filled credentialing applications and supporting documentation.
- Created facility agreements for lines of business upon approval by Credentialing.
- Led training sessions to onboard new providers
- Implemented effective strategies through service visits to enhance the learning experience of NF staff.
- Successfully handled updates to provider demographics such as tax identification numbers and addresses, ensuring accuracy and addressing any discrepancies.
- Maintained adherence to all compliance requirements pertaining to the operations of the Provider Relations Department, per state, local, and federal guidelines.
- Analyzed complex information from multiple sources to identify patterns or trends.
- Identified needs of customers promptly and efficiently.
LTSS Provider Service Rep
Molina Health Care of Texas
02.2012 - 03.2015
- Supported strategies for managing an effective provider network by identifying network composition gaps and collaborating with network contracting staff to prioritize contracting requirements; solved operational deficiencies and conducted research to resolve claims issues.
- Learned new healthcare information systems and applicable software programs, while developing, organizing, analyzing, documenting, and implementing processes and procedures as prescribed by Plan policies. Communicated comfortably and effectively with all levels of the healthcare organization, within both corporate and regional market environments. Maintained skills with a professional demeanor, exhibiting strong interpersonal, verbal, and written communication skills.
- Provided excellent customer service by addressing provider needs in a timely fashion.
- Resolved provider complaints promptly and efficiently.
- Utilized various software applications including MS Office Suite as well as CRM tools such as Salesforce.
- Collaborated with cross-functional teams such as facility staff, technical support, marketing to ensure quality provider service standards are met.
- Assisted providers with account information, billing inquiries, and product and service questions.
Education
Human Resources Management -
Park University
01.2011
Liberal Arts -
Monroe Community College
06.2003
Skills
- Certified Corporate Trainer
- RBLP-T Trainer
- Training programs development and delivery
- Customer service skills
- Communication skills
- Decision-making skills
- Process and procedure implementation
- Customer Relationship Management
- Interpersonal skills
- Verbal and written communication skills
- Organization and flexibility
- Multitasking
- Confidentiality
- HIPAA compliance
- Positive work relationships
Certification
- Certified Corporate Trainer 2024
- Certified Life Coach, 2023
- Certified RBL- Trainer 2022
- Diversity Training 2022
- Sexual Harassment in the Workplace 2022
References
REFERENCES UPON REQUEST
Timeline
Nursing Facility Provider Consultant
Amerigroup
03.2015 - 02.2024
LTSS Provider Service Rep
Molina Health Care of Texas
02.2012 - 03.2015
Human Resources Management -
Park University
Liberal Arts -
Monroe Community College
- Certified Corporate Trainer 2024
- Certified Life Coach, 2023
- Certified RBL- Trainer 2022
- Diversity Training 2022
- Sexual Harassment in the Workplace 2022
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