
Dynamic professional with extensive experience in the health insurance industry, including roles at Optum and Aetna. Proven track record in provider relations and contract management, demonstrating reliability and exceptional customer service. Skilled in Medicaid and Medicare processes, with a focus on enhancing provider satisfaction and streamlining operations.
*Provider Education regarding Commercial, Medicare, and Medicaid lines of business
*Roster confirmation
*Claims Resolution
*Routine touch base meetings
*Quarterly meetings
*Credentialing and contracting updates
*Managing Inpatient and ancillary payment appendices for FL, TN, IN, and MI as well as base appendices
*Work closely with legal and vetting administration to ensure contract language and fees are up to date and accurate
*Provide support for coding research, network and contracting support as needed