Rodney J. Byrd
Chapel Hill,NC
Summary
Dynamic Provider Information Specialist with a proven track record at BlueCross BlueShield of North Carolina, adept in regulatory compliance and team leadership. Expert in enhancing provider satisfaction and revenue through strategic thinking and operational management. Demonstrated ability to resolve complex claims and increase access to prescribed therapies, ensuring compliance and excellence in healthcare services.
Overview
16
16
years of professional experience
Work History
Provider Information Specialist
BlueCross BlueShield of North Carolina
Durham, NC
10.2022 - Current
- Compile appropriate information to make requested contractual and demographic updates and changes related to provider data in the systems of record in an accurate, complete and timely manner
- Provide cross functional support and serve as subject matter expert to internal and external provider teams
- Configure providers and networks in systems of record, assign provider numbers and communicate with provider community
- Research, respond to, analyze and resolve complex claims issues to provider setup and provider eligibility
- Represent BCBSNC to external provider communities and internal stakeholder groups
- Generate resolution documents to resolve provider issues and increase provider satisfaction
- Identify, understand, and anticipate providers’ unexpressed needs and concerns
Reimbursement Specialist
TrialCard
Morrisville, NC
11.2019 - 10.2022
- Handled benefits investigations, prior authorizations, appeals support, and adverse event reporting effectively.
- Completed medical and/or pharmacy benefit investigations, identified, and facilitated the submission of required documentation for payer/plan review for prior authorization, step edit identification, and appeals according to program standard operating procedures.
- Exhibited in-depth knowledge of diverse payer systems encompassing both private/commercial sectors and government entities.
- Maintained records in accordance with applicable standards and regulations for the programs/promotions responsible for determining coverage availability and coordinating the financial aspects of healthcare services to ensure patients have access to prescribed therapies.
- Ensured compliance by managing processes for Adverse Event reporting.
Account Manager
Dudley Beauty Corporation, LLC
High Point, North Carolina
02.2012 - 12.2018
- Developed a territory based on local industry needs with strategic partnerships to exceed customer needs throughout the Raleigh, Durham and Chapel Hill metropolitan areas of North Carolina. Serve as an authorized distributor of 200+ Dudley Beauty Corp, LLC products to licensed cosmetologists, barbers, and beauty school
- Achieved a 110% expansion in territory revenue, strengthening market presence.
- Coordinated educational seminars tailored for licensed beauty professionals within the Raleigh/Durham region.
- Achieved a 75% increase in customer base through effective sales strategies, repeat business, and client referrals.
Sales Representative
Salon Exclusive
Greensboro, North Carolina
02.2009 - 02.2012
- Sold and distributed professional hair products, equipment, and supplies to over 250 hair care professionals in the Greensboro metropolitan area.
- Engaged with prospective customers while executing the full sales cycle, including gathering their business needs, proposing valued product solutions, negotiating pricing terms, closing deals, and following up to ensure complete satisfaction.
- Achieved a 50% revenue increase in the first 18 months.
- Managed complex customer interactions involving sales, delivery, and product issues.
- Provided comprehensive product knowledge to educate both current and prospective clients.
- Spearheaded coordination of trade shows to attract clients and market-specific company brands.
- Recruited skilled professionals to conduct engaging product demonstrations.
- Supported certification efforts of industry experts by allocating cosmetology credit through demonstration events at trade shows.
Education
Bachelor of Arts - Management & Society
University of North Carolina at Chapel Hill
Chapel Hill08.2008
Skills
- Regulatory compliance
- Opportunity Identification
- Operations Management
- Training Development
- Risk Management
- Revenue Enhancement Strategies
- Team Leadership
- Project management
- Strategic thinking
- Sales management
Professional Associations
Kappa Alpha Psi Fraternity, Inc., Kappa Charitable Trust Fund, Inc. Board of Directors, Secretary
Technology Summary
- Microsoft Office Suite
- Salesforce.com
- NPM (Change Healthcare/Provider Manager)
- Facets
- PowerMHS
- Intermediate fluency in Spanish (reading, writing, and speaking)
Timeline
Provider Information Specialist
BlueCross BlueShield of North Carolina
10.2022 - Current
Reimbursement Specialist
TrialCard
11.2019 - 10.2022
Account Manager
Dudley Beauty Corporation, LLC
02.2012 - 12.2018
Sales Representative
Salon Exclusive
02.2009 - 02.2012
Bachelor of Arts - Management & Society
University of North Carolina at Chapel Hill
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