STEPHANIE A. JOYNER
Millersville,MD
Summary
Healthcare relationship management professional with 20+ years of experience across provider relations, federal employee benefits, and healthcare operations. Experienced in working with commercial and self-funded plan structures and serving as a trusted liaison to hospitals and health systems. Known for clear communication, steady execution, and the ability to resolve complex issues while maintaining strong professional relationships. Comfortable presenting to leadership, interpreting policy, and partnering across departments to move work forward.
Overview
21
21
years of professional experience
Work History
Provider Relations Representative II
CareFirst BlueCross BlueShield
Columbia, MD
07.2024 - Current
- Promoted to Representative II based on performance, reliability, and ability to independently manage hospital partnerships
- Serve as primary liaison to 25+ hospitals and health systems across DC, Maryland, and Virginia
- Lead quarterly meetings with hospital and provider leadership, including behavioral health and DSNP forums
- Conduct monthly Joint Operating Committee (JOC) meetings to address escalations, performance trends, and operational concerns
- Research and resolve complex provider issues related to claims, billing, contract interpretation, and policy application
- Provide ongoing provider education to support correct process use and effective portal navigation
- Partner across Claims, Accounting, and Clinical Appeals to identify root causes and facilitate timely resolution
- Support special initiatives tied to provider experience, quality measures, and operational improvements
Provider Relations Representative I
CareFirst BlueCross BlueShield
Columbia, MD
05.2022 - 07.2024
- Promoted to Representative II based on performance, reliability, and ability to independently manage hospital partnerships
- Serve as primary liaison to 25+ hospitals and health systems across DC, Maryland, and Virginia
- Lead quarterly meetings with hospital and provider leadership, including behavioral health and DSNP forums
- Conduct monthly Joint Operating Committee (JOC) meetings to address escalations, performance trends, and operational concerns
- Research and resolve complex provider issues related to claims, billing, contract interpretation, and policy application
- Provide ongoing provider education to support correct process use and effective portal navigation
- Partner across Claims, Accounting, and Clinical Appeals to identify root causes and facilitate timely resolution
- Support special initiatives tied to provider experience, quality measures, and operational improvements
Senior Customer Service Advocate
Senior Customer Service Advocate (Member Services → Provider Services)
Washington, DC
08.2020 - 05.2022
- Hired as a Senior Advocate supporting Member Services, with primary responsibility for Federal Employee Program (FEP) inquiries
- Educated federal members on plan benefits, eligibility, coverage differences, and policy guidelines to ensure clear understanding of coverage and next steps
- Utilized CXP (Salesforce-based CRM platform) to document cases, track follow-up actions, and maintain accurate records
- Interpreted plan language and benefit policy to research and resolve complex claims and coverage questions
- Met or exceeded departmental quality and compliance standards on evaluated FEP calls, maintaining accuracy and HIPAA adherence
- Transferred to Provider Services, expanding scope to include provider-facing claim research, billing inquiries, and payment investigations
- Selected to serve on a dedicated escalation team responsible for resolving provider correspondence and complex cases approaching the 14-day compliance deadline
- Coordinated across Accounting Services, Claims, and Clinical Appeals to facilitate timely case closure
- Identified recurring claims and benefit concerns and elevated patterns to leadership to support process improvements
Open Season Task Force
Open Season Task Force – Federal Markets (Contract/Seasonal)
Washington, DC
10.2019 - 12.2019
- Represented BCBS PPO (FEP Standard, Basic, BlueFocus), CareFirst Blue Choice HMO, FEP BlueDental, and FEP BlueVision at federal agency health fairs
- Educated federal employees and retirees on plan differences, benefit changes, and enrollment options
- Supported acquisition and retention efforts during Open Season while adhering to OPM and FEHBP guidelines
- Recognized as 2019 “Rookie of the Year” for performance and service excellence
Operating Room Surgical Scheduler
Anne Arundel Medical Center
Annapolis, MD
04.2008 - 04.2016
- Coordinated inpatient and outpatient surgical procedures across multidisciplinary teams
- Verified insurance eligibility and initiated claims investigations
- Managed confidential patient data and supported operational efficiency
- Provided exceptional customer service when addressing patient inquiries or concerns regarding their scheduled surgeries.
- Served as a key liaison between patients, physicians, and hospital staff, fostering strong relationships that supported effective care coordination.
Surgical Coordinator & Service Advisor
Greater Washington Orthopedic Group
Silver Spring, MD
01.2005 - 04.2008
- Managed high-volume patient inquiries related to coverage, billing, and pre-authorizations
- Advised insurers regarding eligibility, deductibles, and coordination of benefits
- Managed patient pre-operative assessments, ensuring compliance with medical protocols and enhancing safety measures.
- Implemented process improvements that reduced patient wait times, enhancing overall service delivery in the surgical scheduling department.
- Served as a liaison between patients, families, clinicians, and hospital staff throughout the entire surgical process.
- Supported seven on-call surgeons with scheduling and administrative coordination
Education
Practical Nursing Certificate - Practical Nursing
Harrison Center For Career Education
Washington, DCSkills
- Provider & Health System Relationship Management
- Commercial, Self-Funded & Federal Plan Knowledge
- Provider Training and Education
- Escalation & Complex Issue Resolution
- Contract & Policy Interpretation
- Managed Care Operations & Reimbursement
- Cross-Department Collaboration
- Hospital Leadership Presentations
- CRM Documentation (CXP/Salesforce)
- Microsoft Office Salesforce EMR Epic
Timeline
Provider Relations Representative II
CareFirst BlueCross BlueShield
07.2024 - Current
Provider Relations Representative I
CareFirst BlueCross BlueShield
05.2022 - 07.2024
Senior Customer Service Advocate
Senior Customer Service Advocate (Member Services → Provider Services)
08.2020 - 05.2022
Open Season Task Force
Open Season Task Force – Federal Markets (Contract/Seasonal)
10.2019 - 12.2019
Operating Room Surgical Scheduler
Anne Arundel Medical Center
04.2008 - 04.2016
Surgical Coordinator & Service Advisor
Greater Washington Orthopedic Group
01.2005 - 04.2008
Practical Nursing Certificate - Practical Nursing
Harrison Center For Career Education
Licensure & Professional Development
Maryland Life & Health Insurance License — In Progress