Robert Napoli
Millbrook,NY
Summary
Dedicated Senior Data Provider Analyst ready to take on a new challenge. I have a proven track record of ensuring member and provider satisfaction and am committed to finding effective solutions that improve provider relationships.
Overview
7
7
years of professional experience
Work History
Senior Provider Data Analyst
UnitedHealth Group
02.2022 - Current
- Validate and authenticate non-participating providers upon submission of their first claim
- Perform research to confirm the identity of new providers and identify suspect behavior
- Conduct provider interviews to verify claim details and demographic information
- Utilize multiple systems (NDB, Phycon, EPIM) and both internal and external websites to gather data
- Document Authentication activities and findings in proprietary database
- Assess research and determine whether provider data should be loaded into NDB or if additional investigation is warranted
- Actively participate in projects as assigned
- Ability to apply existing/established knowledge to varied scenarios
- Collaborate with colleagues when needed to identify and resolve problems
- Attend required and suggested meetings to understand business needs
- Meet and exceed Quality, Productivity and Attendance requirements
Senior Customer Service Representative
UnitedHealth Care, UnitedHealth Group
11.2016 - 02.2022
- Provide excellent customer service to ensure member and provider satisfaction
- Investigate and resolve all customer and provider inquires and issues regarding eligibility, benefits, and claims
- Review claim and appeal details with members and providers to determine if processed properly and escalate if necessary
- Backup Subject Matter Expert (SME)
- Took on added responsibilities of handling Work related injury (AO) issues, Prior Authorization Intakes, and Retirement Specialist
- Utilize multiple computer systems to ensure accurate information over multiple plans
Education
Bachelor of Arts - Mathematics
State University of NY At Plattsburgh
Plattsburgh, NY12.1988
Skills
- Analytical Problem Solving
- Critical thinking
- Data Integrity Validation
- Strong Work Ethic
- Clear and Concise Communication
- Proficient with Microsoft Office
- Query Tools
Timeline
Senior Provider Data Analyst
UnitedHealth Group
02.2022 - Current
Senior Customer Service Representative
UnitedHealth Care, UnitedHealth Group
11.2016 - 02.2022
Bachelor of Arts - Mathematics
State University of NY At Plattsburgh
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